Oncology
Research and
Treatment
Band 47 | Supplement 1 | Februar 2024
36. Deutscher Krebskongress
Fortschritt gemeinsam gestalten
21.–24. Februar 2024, Berlin
Herausgeber:
Reinhard Büttner, Köln
47 | S1 | 24
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Österreichische Gesellschaft für
Hämatologie & Medizinische Onkologie
Offi cial Organ of Editors-in-Chief
Ralf-Dieter Hofheinz – Department of Medical Oncology, University Hospital Mannheim,
Heidelberg University, Mannheim, Germany
Sylvie Lorenzen – Third Department of Internal Medicine (Hematology/Medical Oncology),
Klinikum rechts der Isar, Technichal University Munich, Munich, Germany
Associate Editors
Carola Berking – Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-
University Erlangen-Nürnberg, Erlangen, Germany
Annalen Bleckmann – Department of Medicine A, Hematology, Oncology and Pneumology, Uni-
versity of Münster, Münster, Germany
Carsten Bokemeyer – Department of Oncology, Hematology and Bone Marrow Transplantation
with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg,
Germany
Markus Borner – ONCOCARE am Engeriedspital, Bern, Switzerland
Andreas Burchert – Department of Hematology, Oncology and Immunology, University Hospital
Gießen and Marburg, Campus Marburg, Marburg, Germany
Jens Chemmitz – Internal Medicine, Hematology/Oncology, Palliative Medicine, Evangelisches
Stift St. Martin, Koblenz, Germany
Thomas Decker – Onkologie Hämatologie, Ravensburg, Germany
Hans Theodor Eich – Department of Radiation Oncology, University Hospital Münster, Münster,
Germany
Elena Elez – Medical Oncology Department, Vall d’Hebron Institute of Oncology (VHIO), Barcelona,
Spain
Yesim Erim – Department of Psychosomatic Medicine and Psychotherapy, University Hospital of
Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
Markus Essler – Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
Thomas J. Ettrich – Department of Internal Medicine I, Ulm University Hospital, Ulm, Germany
Helmut Friess – Department of Surgery, Klinikum rechts der Isar, Technical University Munich,
Munich, Germany
Emmanouil Fokas – Department of Radiotherapy and Oncology, University Hospital Frankfurt,
Goethe-University Frankfurt, Frankfurt, Germany
Frank Griesinger – University Hospital Internal Medicine-Oncology, Pius Hospital, Universiy Medi-
cine Oldenburg, Oldenburg, Germany
Axel Heidenreich – Department of Urology, University Hospital Cologne, University of Cologne,
Cologne, Germany
Member of Deutsche Krebsgesellschaft e.V.
S. Eckhardt (1978–1989), R. Gross (1978–1980), J.H. Holzner (1978–1990), N. Jaeger (1978–1980),
K. Munk (1978–1980), G.P. Murphy 1978–1980), J.P. Obrecht (1978–1979), A. Stacher (1978–1980),
St. Tanneberger (1978–1980), W. Wilmanns (1978–1980), H. Wrba (1978–1980), G.A. Nagel (1981–1988),
W. Queißer (1989–2002), W. Huber (1992–1998), H.-J. Schmoll (2002–2012), M. Hallek (2011–2020)
Oncology
Research and
Treatment
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Marcus Hentrich – Department of Hematology and Oncology, Red Cross Hospital Munich, Munich,
Germany
Philipp Ivanyi – Department of Hematology, Hemostaseology, Oncology and Stem Cell Transplan-
tation, Medical School Hannover, Hannover Germany
Wolfgang Janni – Department of Obstetrics and Gynecology, University of Ulm, Ulm, Germany
Jens Peter Klussmann – Department of Otolaryngology (Head and Neck Surgery), University Hospi-
tal Cologne, University of Cologne, Cologne, Germany
Matthias Kroiss – Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
Hauke Lang – Department of General, Visceral and Transplant Surgery, University Medical Center,
Johannes Gutenberg University Mainz, Mainz, Germany
Anne Letsch – Department of Medicine II, Hematology and Oncology, University Hospital
Schleswig-Holstein, Kiel, Germany
Lars Lindner – Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
Wolfram Malter – Department of Obstetrics and Gynecology, Cologne University Hospital, Univer-
sity of Cologne, Cologne, Germany
Volkmar Müller – Department of Gynecology, University Medical Center Hamburg-Eppendorf,
Hamburg, Germany
Christian Pallasch – Department I of Internal Medicine and Center of Integrated Oncology, University
Hospital Cologne, University of Cologne, Cologne, Germany
Peter Reichardt – Department of Oncology and Palliative Care, Sarcoma Center Berlin-Branden-
burg, Helios Klinikum Berlin-Buch, Berlin, Germany
Guido Reifenberger – Department of Neuropathology, Medical Faculty, Heinrich Heine University,
Düsseldorf, Germany
Anke Reinacher-Schick – Department of Hematology, Oncology and Palliative Care, Ruhr-Universi-
ty Bochum, Bochum, Germany
Friedemann Schad – Department of Interdisciplinary Oncology and Palliate Medicine, Gemein-
schaftskrankenhaus Havelhöhe, Berlin, Germany
Marc Schlaeppi – Center for Integrative Medicine, Cantonal Hospital St Gallen, St Gallen, Switzer-
land
Marcus Schmidt – Department of Obstetrics and Gynecology, University Medical Center Mainz,
Johannes Gutenberg University Mainz, Mainz, Germany
Matthias Theobald Third Department of Medicine (Hematology, Oncology, and Pneumology),
University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
Michael Thomas Department of Thoracic Oncology, Translational Lung Research Center Heidel-
berg, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
Michael von Bergwelt – Department of Medicine III, University Hospital, LMU Munich, Munich,
Germany
Marie von Lilienfeld-Toal – Institute of Diversity Medicine, c/o Deanery of the Medical Faculty,
Bochum, Germany
Ulrich Wedding – Department of Medicine II, University Hospital Jena, Jena, Germany
Editorial Board
Peter Albers – Department of Urology, Düsseldorf University Hospital, Düsseldorf, Germany
Dirk Arnold – Department of Oncology, Asklepios Tumorzentrum Hamburg, AK Altona, Hamburg,
Germany
Akin Atmaca – Department of Oncology and Hematology, Krankenhaus Nordwest, UCT-University
Cancer Center, Frankfurt/M., Germany
Claudia Bausewein – Department of Palliative Medicine, University Hospital, LMU Munich, Munich,
Germany
Dirk Beutner – Department of Otorhinolaryngology, Head and Neck Surgery, University of Göt-
tingen, Göttingen, Germany
Peter Brossart – Department of Internal Medicine III, University Hospital Bonn, Bonn, Germany
(Continued on next page)
(Continued)
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Andrea D’Aviero – Radiation Oncology, Mater Olbia Hospital, Olbia, Italy
Edgar Dippel – Department of Dermatology, Klinikum Ludwigshafen, Skin Cancer Center Rhein-
pfalz, Ludwigshafen, Germany
Alexander Drzezga – Department of Nuclear Medicine, University of Cologne, Cologne, Germany
Andreas Engert – Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn
Cologne Düsseldorf and German CLL Study Group, University of Cologne, Cologne, Germany
Franziska Geiser – Department of Psychosomatic Medicine and Psychotherapy, University Hospital
Bonn, Bonn, Germany
Ulrich Herrlinger – Division of Clinical Neurooncology, Department of Neurology, Medical Center,
University of Bonn, Bonn, Germany
Andreas Hochhaus – Department of Hematology/Oncology, Clinic of Internal Medicine II, Jena
University Hospital, Friedrich Schiller University Jena, Jena, Germany
Friedemann Honecker – Tumor and Breast Center ZeTuP St. Gallen, St. Gallen, Switzerland
Heinz Kölbl – Department of Obstetrics and Gynecology, Comprehensive Cancer Center, Medical
University of Vienna, Vienna, Austria
Walther Kuhn – Department of Gynecology and Obstetrics, Donau-Isar-Klinikum, Deggendorf,
Germany
Thorsten Langer – Pediatric Oncology and Hematology, University Hospital for Children and Ado-
lescents, University Hospital Schleswig-Holstein, Lübeck, Germany
Peter Mallmann – Department of Obstetrics and Gynecology, Cologne University Hospital, Univer-
sity of Cologne, Cologne, Germany
Anja Mehnert – Department of Medical Psychology and Medical Sociology, University Medical
Center Leipzig, Leipzig, Germany
Holger Moch – Department of Pathology and Molecular Pathology, University Hospital Zurich,
Zurich, Switzerland
Anke Reinacher-Schick – Department of Hematology, Oncology and Palliative Care, Ruhr-
University Bochum, Bochum, Germany
Ingo B. Runnebaum – Department of Gynecology and Reproductive Medicine, Jena University
Hospital, Friedrich-Schiller-University Jena, Jena, Germany
Hans-Ulrich Schildhaus – Institute of Pathology Nordhessen, Kassel, Germany
Patrick Schöffski – Department of General Medical Oncology, University Hospitals Leuven, Leuven
Cancer Institute, Leuven, Belgium
Florian Schütz – Department of Gynecology and Obstetrics, Diakonissen-Stiftungs-Krankenhaus
Speyer, Speyer, Germany
Jalid Sehouli – Department of Gynecology with Center for Oncological Surgery, Charité – Univer-
sitätsmedizin Berlin, Berlin, Germany
Nicole Skoetz – Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn
Cologne Düsseldorf and German CLL Study Group, University of Cologne, Cologne, Germany
Christine Spitzweg – Department of Internal Medicine IV, University Hospital of Munich, LMU
Munich, Munich, Germany
Imke Strohscheer – Deutsche Rentenversicherung Nord, Lübeck, Germany
Selma Ugurel – Department of Dermatology, University Hospital Essen, University Duisburg-Essen,
Essen, Germany
Raymond Voltz – Department of Palliative Medicine, University Hospital Cologne, University of
Cologne, Cologne, Germany
Michael Weller – Department of Neurology, University Hospital and University of Zurich, Zurich,
Switzerland
Jens Werner – Department of General, Visceral, and Transplant Surgery, LMU Munich, Munich,
Germany
Thomas Zander – Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn
Cologne Düsseldorf and German CLL Study Group, University of Cologne, Cologne, Germany
Oliver Zivanovic – Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer
Center, New York, NY, USA
(Continued)
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Journal Information
Aims and Scope
Oncology Research and Treatment offers an interdisciplinary forum for cancer research and
treatment. Peer-reviewed original and review articles cover a wide range of aspects in med-
ical hematology and oncology, surgical, neurosurgical, gynecological, pediatric and uro-
logical oncology, oral and maxillofacial surgery, dermatological oncology, diagnostics, ra-
diation oncology, psychological care, pathology, clinical-translational oncology, biometry,
and oncological rehabilitation. Continuous medical education and clinical news form a fur-
ther focus. Compact and current, Oncology Research and Treatment keeps both clinicians and
researchers up to date.
Oncology Research and Treatment is addressed to clinicians and practitioners working and
researching in the field of hematology and oncology.
ISSN Print Edition: 2296–5270
ISSN Online Edition: 2296–5262
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Onkologie-Studie 2018
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36. Deutscher Krebskongress
Fortschritt gemeinsam gestalten
21.–24. Februar 2024, Berlin
ABSTRACTS
Herausgeber
Reinhard Büttner, Köln
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Disclosure Statement Guest Editor
The Editor declares that he has no conflict of interest.
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Kongresspräsident
Abstract-Gutachter
Reinhard Büttner, Köln
Marius Adler, Göttingen; Bernd Alt-Epping, Heidelberg; Udo Altmann, Essen; Philipp
Arndt, Essen; Dirk Arnold, Hamburg; Beyhan Ataseven, Detmold; Ambros Beer, Ulm;
Meinrad Beer, Ulm; Corinna Bergelt, Greifswald; Dirk Böhmer, Berlin; Servet Bölükbas,
Essen; Thomas Brabletz, Erlangen; Wolfgang Brückl, Nürnberg; Judith Büntzel,
Göttingen; Reinhard Büttner, Köln; Reiner Caspari, Bad Neuenahr-Ahrweiler; Carsten
Denkert, Marburg; Andreas Dinkel, München; Uta Dirksen, Essen; Hans Roland Dürr,
München; Angelika Eggert, Berlin; Rainer Engers, Neuss; Annette Freidank, Fulda; Peter
Friedl, Nijmegen; Jörn Gattermann, Bremen; Florian Gebauer, Wuppertal; Christina
Gerlach, Heidelberg; Roland Goldbrunner, Köln; Ralf Gutzmer, Minden; Boris Hadaschik,
Essen; Ken Herrmann, Essen; Jochen Hess, Heidelberg; Andreas Hochhaus, Jena; Stefan
Höcht, Potsdam; Jens Hoffmann, Berlin; Wilfried Hoffmann, Badenweiler; Wolfgang
Hoffmann, Greifswald; Uta Höpken, Berlin; Rudolf M. Huber, München; Gerdt Hübner,
Oldenburg; Jutta Hübner, Jena; Ulrich Jaehde, Bonn; Jens Jakob, Mannheim; Klaus-Peter
Janssen, München; Ingolf Juhasz-Böss, Freiburg; Lukas Käsmann, München; Alexander
Katalinic, Lübeck; Christian Keinki, Berlin; Ludwig Kiesel, Münster; Alexander Kleger,
Ulm; Aris Koryllos, Düsseldorf; Matthias Kroiss, München; Cornelia Kropf-Sanchen,
Ulm; Stephan Lang, Essen; Cornelia Mauch, Köln; Ilektra-Antonia Mavroeidi, Essen;
Ursula Nestle, Mönchengladbach; Jan Philipp Novotny, Heidelberg; Thorsten Persigehl,
Köln; Joachim Pfannschmidt, Berlin; David Pfister, Köln; Michael Platten, Heidelberg;
Alexander Quaas, Köln; Michael Quante, Freiburg; Christian Reinhardt, Essen; Margitta
Retz, München; Oliver Rick, Bad Wildungen; Stefan Rieken, Göttingen; Felix Carl Saalfeld,
Dresden; Thorsten Schmidt, Lübeck; Tilman Schöning, Heidelberg; Hubert Serve,
Frankfurt; Sebastian Stintzing, Berlin; Herwig Strik, Bamberg; Tim Vilz, Bonn; Meike
Vogler, Frankfurt; Petra Voiss, Essen; Beate Volkmer, Buxtehude; Bastian von Tresckow,
Essen; Thorsten Walles, Magdeburg; Markus Wallwiener, Heidelberg; Wolfgang Walther,
Berlin; Daniel Wecht, Marburg; Ulrich Wedding, Jena; Lisa Wiesmüller, Ulm; Peter J. Wild,
Frankfurt; Jürgen Wolf, Köln; Barbara Wollenberg, München; Rachel Würstlein, München;
Tanja Zimmermann, Hannover; Daniel Zips, Berlin; Johannes Zuber, Wien
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Inhalt
7
8
8
9
10
10
11
12
12
13
13
14
14
16
16
17
17
19
19
24
28
41
47
48
52
53
63
79
89
90
98
Best-of-Abstract-Vortrag
Articial Intelligence in Cancer Care and Diagnostics
Biomarker
Breast Cancer
Central Nervous System
Gastrointestinal Cancer: Colorectal
Gastrointestinal Cancer: other than colorectal
Genitourinary Cancer including Prostate Cancer
Gynecologic Cancer
Head and Neck Cancer
Health Economy/Public Health
Hematooncology including Bone marrow transplantation, Lymphoma,
Plasmocytoma
Imaging
Novel Therapeutics: Targeted Therapies, Immunotherapies, Cellular Therapies
Onkologische Pege
Psychooncology
Sarcoma
Supportive Care
Thoracic Cancer
Poster
Articial Intelligence in Cancer Care and Diagnostics
Biomarker
Breast Cancer
Central Nervous System
Endocrine Tumors
Epidemiology
Epigenetic and Metabolomic Targets
Gastrointestinal Cancer: Colorectal
Gastrointestinal Cancer: other than colorectal
Genitourinary Cancer including Prostate Cancer
Geriatric Oncology
Gynecologic Cancer
Head and Neck Cancer
Health Economy/Public Health 107
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Inhalt
Inhalt
112
124
124
136
140
141
150
151
155
168
171
177
180
192
197
203
206
206
217
218
Hematooncology including Bone marrow transplantation, Lymphoma,
Plasmocytoma
Imaging
Lung Cancer
Molecular Pathology
Novel Therapeutics: Clinical Trials
Novel Therapeutics: Targeted Therapies, Immunotherapies, Cellular Therapies
Oncological Pharmacy
Onkologische Pege
Other Topics
Paediatric Cancer
Palliative Care
Primary and Secondary Prevention
Psychooncology
Radiation
Rehabilitation, Sports Medicine, and Long-term Burden in Cancer Survivors
Sarcoma
Skin Cancer including Melanoma
Supportive Care
Surgical Oncology including Robotics
Thoracic Cancer
Translational Oncology 219
Late-Breaking Abstracts
Best-of-Abstract-Vortrag
Breast Cancer 227
Endocrine Tumors 228
Gastrointestinal Cancer: other than colorectal 228
Genitourinary Cancer including Prostate Cancer 230
Hematooncology including Bone marrow transplantation, Lymphoma,
Plasmocytoma 230
Lung Cancer 231
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Inhalt
232
233
233
234
235
236
236
237
238
239
240
241
241
242
243
247
247
248
249
250
252
253
254
257
257
257
260
260
261
Poster
Articial Intelligence in Cancer Care and Diagnostics
Biomarker
Breast Cancer
Cancer of Unknown Primary (CUP)
Central Nervous System
Endocrine Tumors
Epidemiology
Gastrointestinal Cancer: Colorectal
Gastrointestinal Cancer: other than colorectal
Genitourinary Cancer including Prostate Cancer
Gynecologic Cancer
Head and Neck Cancer
Health Economy/Public Health
Hematooncology including Bone marrow transplantation, Lymphoma,
Plasmocytoma
Lung Cancer
Molecular Pathology
Novel Therapeutics: Targeted Therapies, Immunotherapies, Cellular Therapies
Onkologische Pege
Other Topics
Primary and Secondary Prevention
Psychooncology
Radiation
Rehabilitation, Sports Medicine, and Long-term Burden in Cancer Survivors
Sarcoma
Skin Cancer including Melanoma
Supportive Care
Surgical Oncology including Robotics
Thoracic Cancer
Translational Oncology
Autorenindex 262
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Abstracts
Best-of-Abstract-Vortrag
Articial Intelligence in Cancer Care and
Diagnostics
158
Label-free Infrared Imaging for Cancer Diagnostics
in Computational Pathology
Frederik Großerüschkamp; Stephanie Schörner; Klaus Gerwert
Ruhr-Universität Bochum/Zentrum für Proteindiagnostik (PRODI), Deutschland
Background: Label-free infrared (IR) imaging allows the analysis of
unstained tissue slides. Morphology and molecular composition are
determined by spatially resolved IR spectra. By using articial intelligence
(AI), disease-specic information can thus be obtained. is has already
been successfully used for various cancers, e.g. colon (CC) and lung can-
cer (LC).1,2
Methods: Unstained cancer tissue slides were measured (avg. 30 min/
slide) and analyzed. Cancer regions were rst identied based on AI, e.g.
a convolutional neural network (CNN) CompSegNet for segmentation.
Subsequently, the lesions can be analyzed in more depth using further AI
models to identify molecular changes. Endpoints were always area under
receiver operating characteristic (AUROC) and area under precision
recall curve (AUPRC).
Result: In our most comprehensive study 547 patients (validation n=147)
with CC were analyzed to identify microsatellite instability (MSI). e
MSI classication reached an AUROC of 0.9 and AUPRC of 0.74 (sensi-
tivity 85%, specicity 84%).1 Further, we demonstrated detection down to
mutation status (TP53, EGFR, RAS) in LC adenocarcinomas (sensitivity
95%, specicity 95%, n=214, validation n=60).2
Discussion: MSI classication in CC reaches an AUROC of 0.9 and driver
mutations in LC can be identied. IR imaging achieves comparable results
to the current gold standard staining. Besides, it requires fewer samples
for training when compared to other AI approaches which could facilitate
the development of prognostic/predictive classiers in the setting of ran-
domized controlled trials.
Conclusion: Label-free IR imaging shows its potential for diagnos-
tics. Further larger studies are needed to bring it into translation. e
unstained tissue samples are still available aer analysis for further inves-
tigations. We expect our approach to be a broadly applicable diagnostic
tool in the future.
Indication of source:
1 Gerwert, K., Schörner, S. et al., Eur J Cancer, 2023, 182, 122–131.
2 Goertzen, N. et al., Am J Pathol, 2021, 191, 7, 1269–1280.
Disclosure Statement: e authors declare no conict of interest.
834
Automatic AI-based segmentation of renal tumors on clinical
routine CT data: a multicenter study
Sophie Bachanek; Paul Würzberg; Manuel Nietert; Lutz Trojan;
AnnemarieUhlig; Joachim Lotz; Johannes Uhlig
Universitätsmedizin Göttingen, Göttingen, Deutschland
Background: To develop an automatic segmentation algorithm and vis-
ualisation method for renal tumors using CT studies acquired in clinical
practice.
Methods: Renal tumor patients diagnosed between 2018 and 2021 were
retrospectively included. Patients aged <18years, and those with cystic or
inltrative renal tumors (i.e. lymphomas) were excluded. All renal tumors
were manually segmented by a GU-radiologist on all axial CT slices. A
convolutional neural network (UNET) was trained on a subset of manual
segmented CT-studies. Internal validation was performed on a subset of
20% of the training data. An external dataset (publicly available KITS-
2019 TCIA dataset) was used for independent model testing. e perfor-
mance of the UNETs predictions for renal tumor contours was compared
to manual segmentations and quantied by the DICE score.
Result: e training dataset contained n=639 patients (37% female;
median age 66y; median tumor diameter 47mm) with CT-studies from
more than 25 radiological centers with varying image quality. In the inter-
nal validation dataset, all renal tumors were at least partially identied by
the UNET (100% of renal tumors with DICE-Score > 0). e median DICE
score was 0.82-0.84. In the external testing dataset, a total of n=208/210
renal tumors (99%) were at least partially identied by our AI algorithm.
e renal tumor segmentation in the independent testing dataset yielded
a median DICE-Score=0.80. UNET segmentation predictions were vis-
ualized using color-coding and contour-lines to depict model and data
uncertainty. Additionally, UNET segmentation predictions were overlaid
on clinical CT images to provide visual feedback.
Discussion: Utilization of color-coding and contour-lines overlaid on
original CT-images provides an explainable approach to the UNETs pre-
dictions and might improve acceptance in clinical practice.
Conclusion: A UNET yields a robust automatic delineation of renal
tumors on CT-studies acquired in clinical routine.
Disclosure Statement: e authors declare no conict of interest.
839
Radiomics and machine learning for the assessment of
renal tumor histological subtypes on multiphase computed
tomography: a multicenter trial with independent testing
Sophie Bachanek1; Andreas Leha1; Philip Zeuschner2;
Alexander Maßmann3; Lutz Trojan1; Johannes Uhlig1; Joachim Lotz1;
Annemarie Uhlig1
1Universitätsmedizin Göttingen, Göttingen, Deutschland
2Universitätsklinikum des Saarlandes, Homburg, Deutschland
3Robert-Bosch-Klinik, Stuttgart, Deutschland
Background: To distinguish histological subtypes of renal tumors identi-
ed on multiphase computed tomography (CT) using radiomic features
and machine learning in a multicenter setting.
Oncol Res Treat 2024;47(suppl 1):7–283
DOI: 10.1159/000535363
© 2024 S. Karger AG, Basel
karger@karger.com
www.karger.com/ort
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts8
Methods: Patients undergoing surgical resection and histopathological
assessment of renal tumors at two tertiary urological centers between 2012-
2022 were retrospectively included. Preoperative arterial and venous phase
CTs from multiple referring imaging centers were segmented and standard-
ized radiomic features extracted. Aer preprocessing and class imbalance, an
extreme gradient boosting tree-based (XGB) machine learning (ML) algo-
rithm was used to predict renal tumor subtypes using 10-fold cross validation,
assessed as multiclass AUC. ML algorithms were trained on data from one
center, and independently tested on data from the other center.
Result: e training cohort comprised n=297 patients (n=191 ccRCC,
n=40 pRCC, n=22 chRCC, n=28 oncocytomas, and n=16 AML), and
the testing cohort n=121 patients (n=68/n=20/n=4/n=26/n=3). e XGB
algorithm demonstrated a diagnostic performance of AUC=0.81/ 0.64/
0.8 for venous / arterial / combined contrast phase CT in the training
cohort, and AUC=0.75/ 0.67/ 0.75 in the independent validation cohort.
In pairwise comparisons, the lowest diagnostic accuracy was evident for
identication of oncocytomas (AUC=0.57-0.69), and the highest for iden-
tication of AMLs (AUC=0.9-0.94).
Discussion: For renal tumor subtype discrimination, venous phase CT
yields the most pertinent imaging information, without evident diagnos-
tic benet of an added arterial contrast phase. Among all renal tumors,
oncocytomas are hardest to dierentiate using CT.
Conclusion: Radiomic feature analyses acquired from clinical routine CT
yield robust results for renal tumor assessment.
Disclosure Statement: e authors declare no conict of interest.
Biomarker
622
Enhancing Personalized Cancer Therapy through
Comprehensive Tumor Proling: Real-World Insights from
Metastatic Patients
Dörthe Scharin-Nabe1; David Reismann2; Stefan Schuster2;
Rudolf Voigtmann1
1Hämatologisch-onkologische Praxis, Bochum, Deutschland
2Datar Cancer Genetics Europe GmbH, Bayreuth, Deutschland
Background: Optimization of cancer therapy using predictive and prog-
nostic biomarkers has advanced, yet their integration into practice remains
complex. Analyzing DNA alterations yields benets in a subset of patients,
leaving gaps in consistent outcomes. Comprehensive tumor proling could
enhance treatment ecacy by identifying actionable tumor characteristics.
Methods: We studied 42 patients with progressive metastatic solid
tumors. We assessed tissue and blood for holistic proling, encompass-
ing genetics, expression, IHC, pharmacogenomics, and chemosensitivity.
Additional data (imaging, ECOG status, etc.) collected over four years
compared progression-free survival (PFS2) aer individualized therapy
with previous treatment (PFS1).
Result: Comprehensive tumor proling led to improved PFS in 66% of
patients, surpassing outcomes of previous treatments (PFS2/PFS1 > 1).
Notably, a subset of patients (29%) demonstrated a twofold increase in
PFS. e median PFS2/PFS1 ratio of 1.25 underscored the clinical signi-
cance of this approach. Univariate analysis unveiled two adverse prognos-
tic scenarios: higher count of oncogenes and presence of p53 mutations.
Interestingly, individualized treatment showed no discernible impact on
ECOG status.
Discussion: Applying personalized treatments is still challenging today
also because initial basket trials failed. With advancing technologies, our
understanding of the heterogeneous tumor biology increases further,
and we understand better how to tailor treatment. Still, for broad clinical
application and acceptance these approaches must become widely availa-
ble and comparable. Finally, the challenges will be to inherit holistic diag-
nostics in guidelines to optimize treatment in the future.
Conclusion: Conuence of proling marks signicant progress. Moving
beyond gene targets, broader considerations lead to informed treat-
ment-strategies. Our study underscores this potential in rening real-
world outcomes and encourages exploration to rethink and rene
personalized cancer therapy.
Disclosure Statement: e authors declare the following: D.R. and S.S. are
employed at Datar Cancer Genetics Europe GmbH, Bayreuth, Germany, focusing
on new diagnostic solutions in oncology. e remaining authors declare no
conict of interest.
Breast Cancer
423
Impact of Dose Reductions on Ecacy of Adjuvant
Abemaciclib for Patients with High Risk Early Breast Cancer
(EBC): Analyses from the monarchE Study
Matthias Zaiss1; Joyce O’shaughnessy2; Irfan Cicin3; Laura Testa4; Sara M.
Tolaney5; Jens Huober6,7; Valentina Guarneri8,9; Stephen R.D. Johnston10;
Miguel Martin11; Priya Rastogi12; Nadia Harbeck13; Hope Rugo14; Ran Wei15;
Valerie Andre15; Ashwin Shahir16; Matthew P. Goetz17
1Praxis für interdisziplinäre Onkologie, Freiburg, Deutschland
2Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, USA
3Trakya University Faculty of Medicine, Edirne, Türkei
4Instituto D’Or de Pesquisa e Ensino (IDOR), Sao Paulo, Brasilien
5Dana-Farber Cancer Institute, Boston, USA
6Cantonal Hospital St. Gallen, Breast Centre St. Gallen, St. Gallen, Schweiz
7University of Ulm, Dept of Gynecology, Ulm, Deutschland
8Department of Surgery, Oncology and Gastroenterology, University of Padova,
Padua, Italien
9Istituto Oncologico Veneto IRCCS, Padua, Italien
10Royal Marsden NHS Foundation Trust, London, United Kingdom
11Hospital General Universitario Gregorio Marañon, Universidad Complutense,
CIBERONC, GEICAM, Madrid, Spanien
12University of Pittsburgh/UPMC, NSABP Foundation, Pittsburgh, USA
13Breast Centre, Department of Gynaecology and Obstetrics, Comprehensive
Cancer Centre München, LMU University Hospital, München, Deutschland
14University of California San Francisco Hellen Diller Family Comprehensive
Cancer Center, San Francisco, USA
15Eli Lilly and Company, Indianapolis, USA
16Loxo@Lilly, Indianapolis, USA
17Department of Oncology, Mayo Clinic, Rochester, USA
Background: Abemaciclib is approved as adjuvant therapy for HR+,
HER2−, high-risk early breast cancer (EBC) based on clinically signi-
cant improvements in invasive disease-free survival (IDFS) and distant
relapse-free survival (DRFS), which were maintained and deepened aer
the 2-year treatment period was completed. In monarchE, 44% of patients
required dose reductions of abemaciclib to proactively manage adverse
events. In abemaciclib MBC trials, similar rates of dose reductions did not
compromise PFS. Here, we present the exploratory analyses to investigate
the impact of dose reductions on ecacy in monarchE.
Methods: In monarchE, up to 2 abemaciclib dose reductions were permit-
ted prior to discontinuation. Pts treated with abemaciclib were classied
into 3 equal-sized subgroups according to their abemaciclib relative dose
intensity (RDI), and IDFS rates were estimated within each subgroup. A
time-dependent Cox proportional hazard (PH) model was also imple-
mented to assess the impact of dose levels over time on IDFS.
Result: Among the 2791 pts treated with abemaciclib, 832 (30%) had 1
and 389 (14%) had 2 dose reductions. Patients ≥65 years old, or those
with ≥4 pre-existing co-morbidities were more likely to have dose reduc-
tions. Across the 3 RDI groups (≤66% vs 66%-93% vs ≥93%), 4-year IDFS
rates were generally consistent (87.1% vs 86.4% vs 83.7% from the lowest
RDI group to the highest). According to the time-dependent model, the
eect of abemaciclib is similar when staying at the full 150-mg dose com-
pared to being dose reduced to either 100 mg or 50 mg (HR=0.905; 95%
CI=0.727, 1.125).
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 9
Discussion: Consistent with observations in the metastatic setting, the
ecacy of adjuvant abemaciclib in monarchE was not compromised by
dose reductions.
Conclusion: Dose reductions should be considered as a safe and eective
way to manage toxicity and retain patients on treatment, in order to main-
tain benet from adjuvant abemaciclib in combination with endocrine
therapy.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
710
Timing of neoadjuvant or adjuvant therapy in patients with
early triple negative breast cancer
Maria Eleni Hatzipanagiotou1; Miriam Pigerl1; Michael Gerken2;
Sophie Raepple1; Verena Zeltner1; Madeleine Hetterich1; Peter Ugocsai1;
Elisabeth C. Inwald1; Monika Klinkhammer-Schalke3; Stephan Seitz1;
Olaf Ortmann1
1Department of Gynecology and Obstetrics, University Medical Centre
Regensburg, Regensburg, Deutschland
2Bavarian Cancer Registry, Regional Centre Regensburg, Bavarian Health and
Food Safety Authority, Regensburg, Deutschland
3Tumor Center - Centre for Quality Management and Health Services Research,
University of Regensburg, Regensburg, Deutschland
Background: To clarify, whether timing of systemic therapy has an impact
on survival in patients with early TNBC.
Methods: Data from a large population-based regional cancer registry
covering 2.2 million people was used for evaluation, including women
with diagnoses of TNBC between 2010 and 2018. Patients were catego-
rized into subgroups according to the interval from TNBC pathologic
diagnosis to the date of rst administration of NACT (TTNC) or accord-
ing to the interval from primary surgery to the date of rst administration
of adjuvant chemotherapy (TTAC). Univariable analyses of survival rates
were conducted using the Kaplan-Meier method.
Result: e nal study cohort included 732 patients with early TNBC,
of whom 43.6% were treated with NACT and 40.3% with adjuvant
chemotherapy.
Timing of NACT
270 patients with TNBC treated with NACT had a valid TTNC. Median
follow up was 3.5 years. Patients with TTNC ≤14, ≤42, >42, and >56
days had estimated mean OS of 8.4, 6.9, 4.6, and 3.3 years. Patients
with a TTNC ≤14 days were more likely to survive than patients with a
TTNC ≥ 56 days (p= 0.054). Signicance was barely not reached in the
group of NACT.
Timing of adjuvant chemotherapy
245 patients with TNBC treated with adjuvant chemotherapy had a
valid TTAC. Treatment given within 22-28 days aer surgery led to
the best outcome with a mean OS of 10.2 years, while patients who
started adjuvant chemotherapy aer 6 weeks had a lower median OS of
6.9 years. Patients who received therapy aer 22-28 days demonstrated
signicantly better survival compared to those who received therapy
aer more than 43 days (p=0.033).
Discussion: e results in this study indicate that there are critical time
intervals for initiation of systemic therapy in patients with early TNBC,
with reduced OS if NACT is applied later than 42 days aer diagnosis or if
adjuvant chemotherapy is applied later than 42 days aer surgery.
Conclusion: We recommend not to exceed the 6-week interval until the
initiation of systemic therapy in patients with early TNBC.
Disclosure Statement: e authors declare no conict of interest.
Central Nervous System
368
Validation of a Methylation-based Signature for
Subventricular Zone Involvement in Glioblastoma
Felix Ehret1; Oliver Zühlke1; Leonille Schweizer2; Johannes Kahn3;
Siyer Roohani1; Christoph Csapo-Schmidt2; David Capper 4;
Sebastian Adeberg5; Amir Abdollahi6; Daniel Zips1; Maximilian Knoll6;
David Kaul1
1Charité - Universitätsmedizin Berlin, Klinik für Radioonkologie und
Strahlentherapie, Berlin, Deutschland
2Universitätsklinik Frankfurt Main, Neurologisches Institut, Frankfurt,
Deutschland
3Charité - Universitätsmedizin Berlin, Institut für Neuroradiologie, Berlin,
Deutschland
4Klinik für Radioonkologie und Strahlentherapie, Institut für Neuropathologie,
Berlin, Deutschland
5Universitätsklinik Marburg, Klinik für Radioonkologie, Marburg, Deutschland
6DKFZ, Heidelberg, Deutschland
Background: Glioblastomas (GBM) with subventricular zone (SVZ) con-
tact have been associated with a specic epigenetic ngerprint. Here, we aim
to validate a reported bulk methylation signature to determine SVZ contact.
Methods: Illumina Human EPIC methylation array analysis was per-
formed on IDHwt GBM patients, the v11b4 classier was used to assure
the inclusion of only RTK I, II, and MES subtypes. Methylation-based
assignment (SVZM+/-) was performed using hierarchical cluster analysis.
Preoperative MRI (T1ce, T2) was independently reviewed for SVZ con-
tact by three experienced readers, two neuroradiologists, and one radia-
tion oncologist. e prognostic value of SVZ/SVZM was evaluated with
Cox-PH models.
Result: Sixty-ve samples were classied as RTK I, II, and MES. Full
T1ce MR-based rater consensus was observed in 54 cases, which were
retained for further analysis. Epigenetic SVZM classication and SVZ
were strongly associated (OR: 15.0, 95% CI: 1.8-711.5, p=0.003). irteen
of fourteen dierential CpGs on whole EPIC arrays (SVZM+ vs. SVZM-,
Bonferroni adjusted p<0.05) were located sequentially in the previously
described dierentially methylated LRBA/MAB21L2 locus. SVZ+ tumors
were linked to shorter OS (HR: 3.80 [1.23-11.75], p=0.03), as was SVZM+
at earlier time points (time-dependency of SVZM, p<0.05). Considering
the SVZ consensus as the ground truth, SVZM classication yields a sen-
sitivity of 96.6%, specicity of 36.0%, positive predictive value (PPV) of
63.6%, and negative predictive value (NPV) of 90.0%.
Discussion: Herein, we validated the epigenetic signature in GBM located
in the vicinity of the SVZ to highlight the importance of methylation of
a part of the MAB21L2/LRBA gene locus. Whether SVZM can replace
MRI-based SVZ assignment as a prognostic and diagnostic tool will
require prospective studies with larger and more homogeneous cohorts.
Conclusion: A DNA methylation-based SVZ signature could become a
valuable tool in the molecular and spatial characterization of GBM.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts10
Gastrointestinal Cancer: Colorectal
694
Lipid metabolism as critical link between gut microbiota
andcolorectal cancer
Florian Jokisch1; Anna Sichler1; Sven Hermeling2;
Josef Ecker2; Klaus-Peter Janssen1
1Klinikum rechts der Isar der Technischen Universität München, München,
Deutschland
2Technische Universität München, München, Deutschland
Background: Deregulated lipid metabolism is a hallmark of cancer cells,
yet its causal contribution to tumor initiation and progression, as well as
the functional connection with the gut microbiota and its metabolites is
largely unclear.
Methods: To address these open questions, mouse models (APC1638N/
APCmin) are considered under germ-free and SPF conditions, in which
features of lipid metabolism in human CRC are preserved. Tissue samples
are analyzed on histology and molecular level. Colon content will be used
for shallow metagenomic sequencing to monitor gut microbial composi-
tion. Patient-derived organoids, as well as clinical patient samples (three
independent cohorts, n=150) will be analyzed. MS-based lipidomics anal-
ysis will be carried out in cooperation with partners at TUM.
Result: Our group has already shown that the gut microbiota promotes
host lipid synthesis in the regenerating liver by providing SCFA, and they
limit intestinal lipid absorption. In fact, a deregulated lipid signature was
found in human CRC tissue and levels of dietary-derived PUFA in blood,
liver and intestine were clearly associated with the presence of gut micro-
biota. Moreover, we showed that SCD1 was positively regulated by gut
microbiota, signicantly increased in human CRC, and negatively asso-
ciated with prognosis.
Discussion: Preliminary results gathered evidence that the gut microbi-
ome interacts with the host cancer cell lipid metabolism at multiple and
non-redundant layers. Lipid metabolism is altered and contributes to
cancer formation in human CRC and cancer mouse models. SCD1 seems
to play a functional, tumor-promoting role in cancer cells and is causally
regulated by the microbiota.
Conclusion: To further allow new insights into the triad “Gut Microbiota
- Lipid Metabolism – CRC”, details on how gut microbiota causally impact
cancer cell lipid metabolism needs to be revealed. We aim to tackle an
unresolved, timely and clinically relevant scientic question in the eld of
molecular cancer and microbiome research.
Disclosure Statement: e authors declare no conict of interest.
726
HER receptor family synergism in the context of colorectal
cancer (CRC) based on new genetic mouse models
Laura Geyer1; Maik Dahlho 2; Klaus-Peter Janssen1
1Klinikum rechts der Isar der Technischen Universität München (TUM),
Department of Surgery, München, Deutschland
2Institut für In-vivo und In-vitro-Modelle/ Veterinärmedizinische Universität
Wien, Department für biomedizinische Wissenschaften, Wien, Österreich
Background: Epidermal growth factor (EGF) signaling is important for
the initiation, progression, and metastasis of cancer, mediated by the
HER/ERBB receptor family. Intratumoral overexpression of HER4 cor-
relates with bad prognosis in colorectal carcinoma (CRC), yet its func-
tion and interplay with other family members like EGFR, remains poorly
understood.
Methods: We established an intestinal epithelial cell specic deletion
(ΔIEC) of either Her4 or Egfr, or compound deletion in a tumor prone
mouse model (Apcmin/+). Tumor phenotypes and tissue was analyzed on
histological and molecular level. Furthermore, 3D organoid cultures from
tumor and intestinal tissues were generated. To extend the in vivo ndings,
HER-receptor CRISPR-Cas9 mediated knockouts were engineered in two
colorectal cancer cell lines.
Result: A signicant increase in tumor number and size was found in
compound mutant mice (Her4ΔIECxEgfrΔIECxApcmin/+) compared to single
knockout and Apcmin/+ controls. Of note, the respective single gene de-
ciencies had less of an eect on tumor initiation (number), but more on
tumor progression (size and anatomical localization) in the Apcmin/+ back-
ground. Moreover, organoids (normal and tumor) could be successfully
established from all genetic lines. Interestingly, tumor organoids from an
Egfr-decient background reproducibly failed to grow, which contrasts the
in vivo phenotype, in which loss of Egfr had no eect on tumor initiation.
Discussion: is unexpected phenotype seems to indicate a synergistic
eect due to the loss of both receptors (Her1 and Her4) which manifests
itself in earlier tumor initiation and progression. To further unravel this
receptor interplay on a deeper molecular level, RNA sequencing and pro-
teomic analysis of tissue and organoid samples will be conducted.
Conclusion: Analysis of the HER4-EGFR interplay may provide import-
ant insights regarding therapeutic strategies for patients with CRC, espe-
cially in cases of anti-EGFR therapy resistance.
Disclosure Statement: e authors declare no conict of interest.
Gastrointestinal Cancer: other than colorectal
273
Adjuvant nivolumab (NIVO) vs placebo (PBO) in resected
esophageal or gastroesophageal junction cancer (EC/GEJC)
following neoadjuvant chemoradiotherapy (CRT): rst report
of comprehensive biomarker analyses from CheckMate 577
Markus Möhler1; Ronan J. Kelly2; Jaer A. Ajani3; Jin Yao4; Jaroslaw
Kuzdzal5; Thomas Zander6; Eric Van Cutsem7; Guillaume Piessen8;
Guillermo Mendez9; Josephine Feliciano10; Satoru Motoyama11;
Astrid Lièvre12; Hope Uronis13; Elena Elimova14; Cecile Grootscholten15;
Karen Geboes16; Yingsi Yang4; Jenny Zhang4; Ruslan Novosiadly4;
James M. Cleary17; Ming Lei4
1Johannes-Gutenberg University Clinic, Mainz, Deutschland
2The Charles A. Sammons Cancer Center at Baylor University Medical Center,
Dallas, TX, USA
3University of Texas MD Anderson Cancer Center, Houston, TX, USA
4Bristol Myers Squibb, Princeton, NJ, USA
5Jagiellonian University, John Paul II Hospital, Krakow, Polen
6University of Cologne, Department of Internal Medicine, Center for Integrated
Oncology Aachen Bonn Cologne Düesseldorf, Gastrointestinal Cancer Group
Cologne (GCGC), Cologne, Deutschland
7University Hospitals Gasthuisberg, Leuven and KU Leuven, Leuven, Belgien
8University of Lille, Claude Huriez University Hospital, Lille, Frankreich
9Fundacion Favaloro, Buenos Aires, Argentinien
10Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore,
MD, USA
11Akita University Hospital, Akita, Japan
12CHU Pontchaillou, Rennes 1 University, Rennes, Frankreich
13Duke Cancer Institute, Durham, NC, USA
14Princess Margaret Cancer Centre, Toronto, ON, Canada
15Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam,
Netherlands Antilles
16UZ Gent, Gent, Belgien
17Dana Farber Cancer Institute, Boston, MA, USA
Background: Adjuvant NIVO demonstrated statistically signicant and
clinically meaningful improvement in disease-free survival (DFS) vs PBO
and an acceptable safety prole in resected EC/GEJC aer neoadjuvant
CRT in CheckMate 577. We present new exploratory biomarker analyses
from this study.
Methods: Whole exome sequencing (WES) of baseline post-CRT tumor
tissue and matching blood was performed to assess microsatellite insta-
bility (MSI), tumor mutational burden (TMB), and select gene muta-
tions. TMB-high (TMB-H) was dened as ≥ 199 mutations/exome. RNA
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 11
sequencing of baseline post-CRT tumor tissue was performed to assess
gene expression signatures (GES). GES subgroups were dened by signa-
ture score tertiles.
Results: 794 patients (pts) were randomized to NIVO or PBO, and the
DFS unstratied hazard ratio (HR) for NIVO vs PBO was 0.68 (95%
condence interval [CI], 0.56–0.83). 374 pts were WES-evaluable,
and the DFS unstratied HR was 0.81 (95% CI 0.60–1.08). Of these,
5 pts were MSI-high (MSI-H), and 13 pts were TMB-H. All MSI-H pts
had adenocarcinoma and were also TMB-H. DFS benet with NIVO
vs PBO was observed regardless of mutational status of select genes,
including PIK3CA, NOTCH1, CDKN2A, and ARID1A. 376 pts were
evaluable for GES, and the DFS unstratied HR was 0.84 (95% CI 0.63–
1.11). GES subgroups were categorized based on high (n = 126; 34%),
medium (n = 125; 33%) or low (n = 125; 33%) tertiles. Improved DFS
benet with NIVO vs PBO was observed in multiple GES subgroups,
including those with higher expression of inammatory and prolifer-
ation GES and lower expression of M2 macrophage, endothelial, and
broblast GES. First results from the dynamics of tumor programmed
death ligand 1 expression pre-/post-CRT and its association with e-
cacy will be presented.
Discussion: ese exploratory analyses indicate improved DFS benet
with NIVO vs PBO in multiple subgroups. e clinical utility of these bio-
markers should be validated in future trials.
Conclusions: ese results further support the benet of adjuvant NIVO
vs PBO in resected EC/GEJC aer neoadjuvant CRT.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
446
Organotypic slice cultures for ex vivo therapy response
prediction of pancreatic cancer
Benjamin Heckelmann1; Olga Lapshyn1; Daniel Fetzner1; Jannis Duhn1;
Anna Maxi Wandmacher2; Louisa Bolm1; Kim Honselmann1;
Oliver Schilling3; Maren Nicole Stillger3; Peter Bronsert3;
Christoph Röcken4; Susanne Sebens2; Tobias Keck1; Ulrich F. Wellner1;
Rüdiger Braun1
1University Clinic Schleswig-Holstein (UKSH) Campus Lübeck, Lübeck,
Deutschland
2Institute for Experimental Tumor Research, Christian-Albrechts-Universität zu
Kiel, Kiel, Deutschland
3Institute of Clinical Pathology, University of Freiburg, Freiburg, Deutschland
4Institute of Pathology, Christian-Albrechts-Universität zu Kiel, Kiel, Deutschland
Background: e poor prognosis of patients with pancreatic cancer
(PDAC) is also due to the limited response to chemotherapeutic agents.
We have established organotypic slice cultures (OTSCs) with the goal
of personalized therapy prediction. e model is characterized by rapid
establishment times and proximity to the original specimens.
Methods: Aer surgical resection and pathological examination, 20 fresh
PDAC tissue samples were cut with a Vibratome and cultivated for up
to 5 days. Standard therapy regimens gemcitabine (+ paclitaxel) and
FOLFIRINOX were added to the cultivation medium. erapy response
was measured by H&E and immunohistochemistry (IHC) staining for
tumor/stroma ratio, proliferation, apoptosis, and immune cell markers.
Digital pathology was used for semi-automatic quantication.
Result: From day 1 to day 5, no substantial structural changes were detected
in the untreated OTSCs. e immune cell populations remained stable for
at least 3 days. Treatments triggered heterogenous tissue reactions between
patients. OTSCs treated with gemcitabine + paclitaxel showed a higher
response rate in IHC stains for tumor cell count, proliferation, and apop-
tosis than OTSCs treated with gemcitabine. FOLFIRINOX-treated OTSCs
showed less proliferating tumor cells and higher rates of necrotic area than
gemcitabine + paclitaxel treated OTSCs. A correlation between treatment
response and survival is provided by the current follow-up of patients.
Discussion: Distinct ex vivo response of dierent patients to the same
treatment regimen indicates individual treatment sensibility between
patients due to intertumoral structural dierences in tissue architec-
ture. OTSCs complement other ex vivo models by enabling evaluation
of the tumor microenvironment, including the stroma and immune
compartment.
Conclusion: OTSCs preserve the multicellular tissue context of PDACs
ex vivo. Immediate establishment aer surgical resection enables rapid
individualized assessment of therapy response ex vivo.
Disclosure Statement: e authors declare no conict of interest.
Genitourinary Cancer including Prostate
Cancer
802
Modeling of an optimal PSA-based risk stratication at age 45
in the PROBASE trial
Agne Krilaviciute1; Maxime de Vrieze1; Axel Benner1; Jale Lakes2;
Markus A. Kuczyk3; Nina Harke3; Jürgen Peter Debus4; Stefan Körber4;
Jürgen Gschwend5; Kathleen Herkommer5; Glen Kristiansen6;
Gerald Antoch7; Lars Schimmöller8; Boris Hadaschik9; Christian Arsov10;
Petra Seibold1; Rudolf Kaaks1; Nikolaus Becker1; Peter Albers1,2
1Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
2UKD - Universitätsklinikum Düsseldorf- Urologische Klinik, Düsseldorf,
Deutschland
3Medizinische Hochschule Hannover, Hannover, Deutschland
4Universitätsklinikum Heidelberg, Heidelberg, Deutschland
5Klinikum rechts der Isar der Technischen Universität München, München,
Deutschland
6UKB Universitätsklinikum Bonn, Bonn, Deutschland
7UKD - Institut für Diagnostische und Interventionelle Radiologie, Düsseldorf,
Deutschland
8Marien Hospital Herne, Herne, Deutschland
9Universitätsklinikum Essen, Essen, Deutschland
10Städtische Kliniken Mönchengladbach GmbH - Betriebsstätte Elisabeth-
Krankenhaus Rheydt Notfall-Ambulanz, Mönchengladbach, Deutschland
Background: Our purpose is to optimize PSA cut-os for risk-adapted
screening invitations. e cut-os used to determine screening intervals
in PROBASE are: PSA <1.5 ng/ml: 5 yrs (low risk); 1.5≤PSA<3: 2 yrs
(intermediate risk); PSA ≥3: MRI + biopsy (high risk).
Methods: PROBASE randomized 23,294 men aged 45 yrs to the immedi-
ate PCa screening arm. Initial risk groups for PCa were reanalyzed using
0.5-sized PSA subgroups (<0.5, ..., 2.5-2.99, ≥3 ng/ml) using data from
subsequent screening rounds at 5 yrs (initial low risk) and 6 yrs (initial
intermediate risk).
Result: Median PSA at 45 was 0.74 ng/ml (IQR 0.5-1.07). When analyzing
the 0.5-sized PSA subgroups, the percentage of men having PSA ≥3 ng/ml
within a median follow-up of 5.05 yrs (IQR 5.0-5.2) increased from 0.2%
(initial PSA <0.5) to 35% (initial PSA 2.5-2.99). Less than 0.1% of men
with initial PSA <1.5 ng/ml were diagnosed with PCa (0.04% of men with
PSA <1 ng/ml). In contrast, 12% of men with an initial PSA of 2.5-2.99
ng/ml had a PCa diagnosis within 6 yrs.
Discussion: In the future, men with low or very low baseline PSA at age 45
may be considered for a longer than 5 yrs screening intervals. is could
help to reduce unnecessary tests and diagnostic procedures triggered by
false-positive PSA elevations. Lowering the PSA threshold to 2.5 ng/ml
at which diagnostics for PCa is indicated might increase the detection of
prevalent cancers, but will also increase the need for additional testing,
e.g. by MRI, to maintain specicity. None of these strategy modications
addresses overdiagnosis and overtreatment though. Routine implemen-
tation of complementary approaches, such as active surveillance (AS)
instead of radical treatment for non-signicant PCa, may be required
before rolling out PSA testing to a population-based screening program.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts12
Conclusion: A baseline PSA <1.5 ng/ml at age 45 is a reliable predictor of
a low risk to develop PCa within 5 yrs. Modeling of an optimal PSA cut-o
for PCa diagnostics needs more data of subsequent screening rounds and
research on acceptance of AS in clinically non-signicant PCa.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
Gynecologic Cancer
716
Assessment of p53 in endometrial carcinoma biopsy and
corresponding hysterectomy specimens in a real world
setting: Which cases need molecular work-up?
Marie-Lisa Eich; Janna Siemanowski; Uta Drebber; Nicolaus Friedrich;
Sabine Merkelbach-Bruse; Birgid Schömig-Markiefka;
Alexander Quaas; Reinhard Büttner
Uniklinik Köln, Köln, Deutschland
Purpose: e WHO straties endometrial cancer into molecular sub-
groups with dierent prognosis leading to dierent treatment options.
One of these subgroups are tumors with abnormal p53. is study is the
rst, which examined p53 immunohistochemistry (IHC) on biopsy and
hysterectomy tissue and investigates the inter-observer variability among
pathologists in a real life clinical practice setting.
Methods: 98 endometrial biopsy and 86 hysterectomy cases from 101
patients were selected (in 83 patients both, biopsy and hysterectomy spec-
imen was available). Five pathologists with dierent levels of experience
independently evaluated p53 IHC staining in all cases. Furthermore, tar-
geted panel sequencing was successfully performed in 169/184 cases.
Results: In 14.3% to 23% of biopsy cases and 3.5% to 32.6% of resection
cases pathologists would perform molecular analysis for TP53 status inde-
pendently of their level of work experience.
When compared to the molecular TP53 status, pathologist’s individual
kappa values ranged from 0.61 to 1.0 for biopsy cases, considering only
cases, where pathologists relied on IHC evaluation without performing
molecular analysis. For resection cases, kappa values ranged from 0.83
to 1. In cases all pathologists agreed on IHC p53 status, molecular anal-
ysis showed the same results in 42/42 of evaluable wild type and 3/3 of
mutated biopsy cases and 42/42 of evaluable wild type and 5/5 mutated
resection cases.
Discussion: Although staining intensity varies considerably between
biopsy and hysterectomy specimens IHC p53 status showed a 100%
accordance with molecular TP53 status, when all ve pathologists agreed.
Moreover, cases scored by pathologists with experience in p53 evaluation
showed a high agreement with molecular status (kappa levels up to 1).
However, pathologists would have required molecular work-up in up to
1/3 of all cases.
Conclusion: IHC p53 can serve as a surrogate marker, if pathologists
received adequate training for evaluation. Molecular analysis should be
performed in all equivocal cases.
Disclosure Statement: e authors declare the following: Unternehmen der
Gesundheitswirtscha.
Head and Neck Cancer
332
Analysis of the tumor immune microenvironment in advanced
adenoid cystic carcinoma
Erika Zuljan1; Eric Blanc1; Benjamin von der Emde2; Iris Piwonski2;
Frederick Klauschen2; Ingeborg Tinhofer-Keilholz2; Andreas Mock3;
Peter Horak4; Ulrich Keller2; Konrad Klinghammer2; Stefan Fröhling4;
Sebastian Ochsenreither2; Ulrich Keilholz2; Dieter Beule1; Damian Rieke1
1Berlin Institute of Health (BIH), Berlin, Deutschland
2Charité, Berlin, Deutschland
3Ludwig-Maximilians-Universität München (LMU), München, Deutschland
4Nationales Centrum für Tumorerkrankungen – NCT, Heidelberg, Deutschland
Background: Adenoid cystic carcinoma (ACC) is a malignant tumor that
can arise from several anatomical sites, including the salivary glands. It is
characterized by high rates of recurrence/metastasis, an immune depleted
microenvironment and poor response to immunotherapy. e aim of this
study is to characterize the tumor immune microenvironment (TIM) in
advanced ACC in order to identify potential therapeutic targets.
Methods: Advanced ACC from the DKTK MASTER program were ana-
lysed using bulk RNA- (n=57), exome (n=27) and genome sequencing
(n=35). Tumor immune inltration was estimated based on GSVA scores
of published immune-cell signatures. e TMB was calculated based on
genome and exome data as number of non- synonymous mutations per
Mb. Both inammation and TMB were compared to TCGA and pub-
lished ACC data. Immunohistochemistry was used as validation.
Result: Immune inltration was signicantly lower in ACC than in most
tumors sequenced in the Cancer Genome Atlas (TCGA). e tumor muta-
tional burden (TMB) was also among the lowest (median: 0.83). No asso-
ciation was found between inammation and TMB or clinical parameters.
RNA-seq immune deconvolution found 3 clusters of immune- inltration
in ACC, with most ACC belonging to the least inamed cluster but iden-
tied an ACC subgroup with high inammation. e immune checkpoint
VTCN1 was found to be signicantly overexpressed in ACC, which was
conrmed by immunohistochemistry.
Discussion: ese data suggest that, although ACC have low inamma-
tion, a small subset of patients show an inamed TIM and might ben-
et from immune checkpoint inhibition. VTCN1 is highly expressed in
tumor cells and could represent a therapeutic target.
Conclusion: Biomarker-stratied immunotherapies should be further
investigated in ACC. A clinical trial of a VTCN1-directed therapy is
ongoing.
Disclosure Statement: e authors declare no conict of interest.
460
Analyses of eector and suppressive B cell populations in
head and neck tumor bearing mice
Michael Sonntag1; Simon Laban1; Marie-Nicole Theodoraki2;
Patrick Schuler1; Thomas Homann1; Cornelia Brunner1
1Department of Otorhinolaryngology, Head and Neck Surgery, Ulm,
Deutschland
2Department of Otorhinolaryngology, Head and Neck Surgery, München,
Deutschland
Background: Tumor-inltrating B cells signicantly aect tumor growth
and treatment ecacy. Diverse B cell subpopulations in the immune
system have a dual role, promoting and inhibiting tumor progression in
Head and Neck Squamous Cell Carcinoma (HNSCC).
Methods: We established an HNSCC murine model by injecting SCC-VII
cells into oral cavities. Aer 21 days, we isolated cells from blood, spleen,
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 13
lymph nodes and tumors, comparing them to healthy controls using ow
cytometry (FACS) and immunohistochemistry (IHC). Enzyme-linked
immunosorbent assays (ELISA) tracked immunoglobulin levels aer
tumor introduction.
Result: GL7+ CD95+ germinal center B cells and CD39+/CD73+ B cells
increased in tumors and spleens of carcinoma-bearing mice. IgM antibody
concentration in mouse serum continuously rose during the observation
period. IgG1, IgG2, and IgG3 levels increased aer isotype switching.
CD39+/CD73+ surface expression was prominent on MZB cells, with less
presence on FO and NF-B cells.
Discussion: Our intervention-triggered antigens exposed tumors, initi-
ating germinal centers and promoting anti-tumoral immune structures
in spleen and tumor tissues. MZ-B cells may have strong immunosup-
pressive potential, shown by increased CD39/CD73 expression in spleen,
lymph nodes, and tumors. Reduced CD39+/CD73+ expression on FO-B
cells in tumor-related tissues, compared to increased expression on MZ-B
cells, highlights distinct roles in tumor progression. IgG1, IgG2, and IgG3
concentrations rising later in the experiment suggests follicular B cells
rene antibodies; elevated IgM levels might result from augmented mar-
ginal zone B cells.
Conclusion: Investigating diverse B cell populations in HNSCC mice and
human patients, despite incomplete understanding of tertiary lymphoid
structures (TLS) implications, promises progress. Unraveling intricate
interactions between B cell subsets and tumor microenvironment oers
innovative ways to enhance HNSCC treatment and prognosis.
Disclosure Statement: e authors declare no conict of interest.
Health Economy/Public Health
663
Financial Distress in German Cancer Patients. Results from
a Quantitative Survey
Sophie Pauge1; Andrea Züger2; Viktoria Mathies3; Katja Mehlis2;
Bastian Surmann1; Thomas Ernst3; Wolfgang Greiner1; Natalja Menold4;
Eva Winkler2; Luise Richter4
1Bielefeld University, Department for Health Economics and Health Care
Management, Bielefeld, Deutschland
2National Center for Tumor Diseases (NCT) Heidelberg, Department of Medical
Oncology, Heidelberg, Deutschland
3Jena University Hospital, Department of Internal Medicine II, Hematology and
Medical Oncology, Jena, Deutschland
4Dresden University of Technology, Institute of Sociology, Dresden, Deutschland
Background: Financial distress due to a cancer disease can impact quality
of life and distress [1]. Despite recognized counseling needs [2], system-
atically collected data on cancer patients’ nancial situation in Germany
remain limited [3]. To assess nancial distress in German cancer patients,
a quantitative survey was performed.
Methods: A paper-pencil survey including 266 cancer patients was
administered at two Comprehensive Cancer Centers. Demographic varia-
bles, disease characteristics, questions on the patients’ nancial situation,
and other patient-reported outcomes such as Depression and Anxiety
(PHQ-4) were included.
Result: On average, patients faced ~1.700€ in cancer-related expenses
over the past six months, including medical costs such as hospital stays
and medications, as well as non-medical expenses such as costs for house-
hold assistance and transportation. Furthermore, ~60% of patients expe-
rienced a signicant loss of income (p<.001), with the average monthly
net income changing from 2.000-2.499€ to 1.500€-1.999€. About 40 per-
cent of respondents reported moderate to severe nancial concerns, for
example regarding their own or their family’s nancial security. Financial
concerns also showed a signicant (p<0.001) association with Depression
(r=0.4) and Anxiety (r=0.4).
Discussion: Financial distress as a possible eect of cancer is a phenome-
non that even occurs in countries with universal healthcare coverage, such
as Germany. It is driven by emerging costs and loss of income due to diag-
nosis and treatment. In addition the link between nancial concerns and
Depression and Anxiety underscores the need for patient support.
Conclusion: Identifying patients at high risk of nancial distress is crucial
for providing personalized and coordinated interventions that can miti-
gate the impact of cancer-related nancial challenges.
Literature:
1 Mehlis, K. et al., BMC Cancer, 2020.
2 Surmann, B. et al., ZEFQ, 2021.
3 Lueckmann, SL et al., Onkologe, 2021.
Disclosure Statement: e authors declare no conict of interest.
Hematooncology including Bone marrow
transplantation, Lymphoma, Plasmocytoma
378
Comprehensive analysis of treatment related morbidity and
progression-free survival in the GHSG phase III HD21 trial
Justin Ferdinandus1,2; Alden Moccia3,4; Richard Greil5,6;
Gundolf Schneider1,2; Valdete Schaub7; Andreas Hüttmann8; Felix Keil6,9;
Judith Dierlamm10; Mathias Hänel11; Urban Novak4,12; Julia Meissner13;
Andreas Zimmermann14; Stephan Mathas15; Andreas Viardot16;
Bernd Hertenstein17; Sonja Martin18; Stefanie Kreissl1,2; Michael Fuchs1,2;
Andreas Rosenwald2,19; Wolfram Klapper2,20; Hans-Theodor Eich2,21;
Christian Baues2,22; Michael Hallek1; Markus Dietlein2,23; Carsten Kobe2,23;
Volker Diehl1,2; Peter Borchmann1,2
1Klinik I für Innere Medizin und CIO Aachen Bonn Köln Düsseldorf, Uniklinik
Köln, Köln, Deutschland
2Deutsche Hodgkin Studiengruppe (GHSG), Köln, Deutschland
3Oncology Institute of Southern Switzerland, Bellinzona, Schweiz
4Swiss Group for Clinical Cancer Research, Bern, Schweiz
5Illrd Medical Department, Paracelsus Medical University, Salzburg, Österreich
6Arbeitsgemeinschaft medikamentöser Tumortherapie (AGMT), Salzburg,
Österreich
7Innere Medizin II, Universitätsklinikum Tübingen, Tübingen, Deutschland
8Klinik für Hämatologie und Stammzell transplantation, Universitätsklinikum
Essen, Essen, Deutschland
93. Medizinische Abteilung, Hanusch Krankenhaus, Wien, Deutschland
10II. Medizinischen Klinik und Poliklinik, Universitätsklinikum Hamburg-
Eppendorf, Hamburg, Deutschland
11Klinik für Innere Medizin III, Klinikum Chemnitz, Chemnitz, Deutschland
12Medizinische Onkologie, Universitätsspital Bern, Bern, Schweiz
13Medizinische Klinik und Poliklinik V, Universitätsklinikum Heidelberg,
Heidelberg, Deutschland
14Medizinische Klinik Und Poliklinik III, Klinikum Der Universität München, LMU
München, München, Deutschland
15Klinik für Hämatologie und Onkologie, Charité Berlin, Berlin, Deutschland
16Klinik für Innere Medizin III, Universitätsklinikum, Ulm, Ulm, Deutschland
17Medizinische Klinik I, Klinikum Bremen-Mitte, Bremen, Deutschland
18Hämatologie, Onkologie und Palliativmedizin, Robert-Bosch-Krankenhaus,
Stuttgart, Deutschland
19Pathologisches Institut, Uniklinikum Würzburg, Würzburg, Deutschland
20Institut für Pathologie Sektion Hämatopathologie, Universitätsklinikum
Schleswig-Holstein, Kiel, Deutschland
21Klinik für Strahlentherapie – Radioonkologie, Universitätsklinikum Münster,
Münster, Deutschland
22Radioonkologie und Strahlentherapie Ruhr-Universität Bochum, Bochum,
Deutschland
23Klinik für Nuklearmedizin, Uniklinik Köln, Köln, Deutschland
Background: e GHSG-HD21 trial for newly diagnosed adult patients
(pts) with advanced-stage classical Hodgkin lymphoma (AS-cHL) com-
pares BrECADD to eBEACOPP. Prior analyses of co-primary endpoints
demonstrated a signicant and relevant reduction in treatment-related
morbidity (TRMB) and non-inferiority of PFS. We report the rst com-
prehensive analysis of the combined primary endpoint of HD21.
Methods: is international open-label phase III trial included adult
pts aged ≤ 60 yrs with AS-cHL. Pts were randomized in a 1:1 ratio to
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts14
PET2-guided 4-6 cycles of either eBEACOPP or BrECADD. PFS was
determined at interim analysis at 36 month FU. PET2 and PFS events were
assessed by blinded panel review. e trial was registered at clinicaltrials.
gov (NCT02661503) and conducted according to ICH-GCP guidelines.
Result: We enrolled 1,500 pts from 9 countries and 233 trial sites between
July 2016 and August 2020. Actual median FU for this analysis was 40
months. e relative risk for a TRMB event was 0.72 (CI95 0.65-0.79) in
favor of BrECADD observed in all subgroups. Fewer dose reductions were
needed with BrECADD than with eBEACOPP. 59% of pts had a PET2-
negative remission (CMR) and were treated with a total of 4 cycles in each
group. At end of chemotherapy, 80% and 82% were in CMR. 3y PFS was
94.9% for BrECADD (CI95 93.5% - 96.7%), and 92.3% for eBEACOPP
(CI95 90.3% - 94.3%; HR 0.63 [CI95 0.42-0.94]). HRs favored BrECADD
consistently across all relevant subgroups. 3y PFS rates for BrECADD
versus eBEACOPP were 97.1% (CI95 95.5% - 98.7%) versus 93.6% (CI95
91.3% - 95.9%) for PET2-negative pts and 93.5% (CI95 90.6% - 96.5%)
versus 90.6% (CI95 87.1% - 94.1%) for PET2-positive pts, respectively.
Discussion: With the novel BrECADD regimen, we observed the highest
3y PFS rates reported to date in a randomized clinical trial in AS-cHL. Our
analyses suggest the unexpectedly high ecacy of the new BrECADD regi-
men to be direct consequence of its improved tolerability and deliverability.
Conclusion: Individualized treatment with 4-6 cycles of BrECADD is a
new standard of care for AS-cHL.
Disclosure Statement: e authors declare the following: Speaker fees received
Roche and Takeda Oncology.
Imaging
754
Impact of FAPI/dual tracer PET/CT imaging on management
and target volume denition of esophageal cancer
Simone Wegen1; Karina Claus1; Philipp Linde1; Johannes Rosenbrock1;
Thomas Zander2,3; Armin Tuchscherer2,3; Wolfgang Schröder4;
Hans Schlößer4,5; Marie-Lisa Eich6; Thomas Fischer7; Klaus Schomäcker7;
Alexander Drzezga7,8; Carsten Kobe7; Katrin Sabine Roth7;
Jasmin Weindler7
1Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of
Medicine and University Hospital Cologne, Cologne, Deutschland
2Department I of Internal Medicine, Faculty of Medicine and University Hospital,
University of Cologne, Cologne, Deutschland
3Center for Integrated Oncology, Faculty of Medicine and University Hospital,
University of Cologne, Cologne, Deutschland
4Department of General, Visceral, Cancer and Transplantation Surgery, Faculty
of Medicine with University Hospital Cologne, Cologne, Deutschland
5Center for Molecular Medicine Cologne, Faculty of Medicine and University
Hospital Cologne, Cologne, Deutschland
6Institute of Pathology, Faculty of Medicine and University Hospital Cologne,
Cologne, Deutschland
7Department of Nuclear Medicine, Faculty of Medicine and University Hospital
Cologne, University of Cologne, Cologne, Deutschland
8Institute of Neuroscience and Medicine, Molecular Organization of the Brain,
Forschungszentrum Jülich, INM-2, Cologne, Deutschland
Background: Fibroblast activation protein (FAP) is expressed in the
tumor microenvironment (TME) of various cancers. We aim to describe
the impact of imaging with radiolabeled inhibitors of FAP (FAPI-46-PET/
CT) and uorodeoxy-D-glucose (FDG-PET/CT) on the management of
esophageal cancer (EC).
Methods:32 patients with EC received FDG and FAPI-46 PET/CT on
the same day (dual-tracer protocol, 71%) or on two separate days (29%).
We compared functional tumor volumes (FTV) in ml and dened gross
tumor volumes (GTV) and cN/cM- tumor stages based on both imag-
ing modalities. Any management changes were categorized as “minor
(adaption/enlargement of radiation (RT) eld) or “major” (change of
treatment). Immunohistochemistry (IHC) staining for FAP was done in
all patients with available tissue.
Results: Primary tumor was detected in all FAPI-46 scans and in 30/32
(93%) of FDG scans. Most FTVs were larger on both dual-tracer PET/
CT (p=0.027) and FAPI-46 PET/CT (p=0.028) compared to FDG PET/CT
alone. 12/32 patients (38%) were upstaged in nodal status aer both FDG
and FAPI-46 PET scan. Here, 10/12 lesions were concordant between both
modalities. ree lymph nodes were visible in FAPI-46/dual-tracer only,
leading to increased RT elds (“minor change”) in 7/32 patients (21%)
and changing treatment regimen (“major change”) in 3/32 patients (9%).
PET scans revealed distant metastasis in 2/32 (6%) patients in the PET
with FAPI-46. GTVs were signicantly larger in FAPI-46/dual-tracer
scans than in FDG PET/CT (mean 99.0ml, SD 98.3 vs. mean 80.3ml, SD
84.4, respectively (p<0.001)). All tissues analysed (43%) showed FAP-
positivity (7%-45% of cells, IHC scoring (H-score) mean 36.3 (SD 24.6)).
Discussion: We report rst data on the use of PET with FAPI-46 prior to
RT indicating relevant impact on management of EC, likely driven by high
FAP expression in the TME. Still, false-positive FAPI-46 PET/CT ndings
should be considered.
Conclusion:PET/CT with FAPI-46 is an attractive staging tool for EC and
leads to changes in treatment. e impact on clinical outcome should be
evaluated prospectively.
Disclosure Statement: e authors declare no conict of interest.
Novel Therapeutics: Targeted Therapies,
Immunotherapies, Cellular Therapies
44
Drug sensitivity proling of 3D tumor tissue cultures in the
pediatric precision oncology program INFORM
Heike Peterziel1; Sonja Herter1; Xenia Gerlo 1; Luisa Becker2;
Robert J Autry2; Tim Holland-Letz3; Annette Kopp-Schneider3;
Olaf Witt1; Ina Oehme1
1DKFZ / KiTZ / NCT, CCU Pediatric Oncology, Heidelberg, Deutschland
2DKFZ / KiTZ / NCT, Division of Pediatric Neurooncology, Heidelberg,
Deutschland
3DKFZ, Division of Biostatistics, Heidelberg, Deutschland
Background: e international precision oncology program INFORM
enrolls relapsed pediatric cancer patients for comprehensive molecular
analysis. We recently implemented functional ex vivo drug sensitivity pro-
ling (DSP) in this international multicenter precision oncology program
(1). Here, we will provide an update on the progress on predictivity of the
pipeline.
Methods: We received 350 viable tumor samples from 35 pediatric oncol-
ogy centers in seven countries. DSP was conducted on multicellular fresh
tumor tissue spheroid cultures in 384-well plates and metabolic viability
read-out; hits were reported to the respective tumor board within three
weeks.
Result: In 204 cases (58%), sucient viable tissue was received and passed
internal quality controls. e DSP results matched the identied molecular
targets, including ALK, MET, and TP53 status. Unexpected drug vulner-
abilities were identied in 80% of cases lacking actionable clinically rele-
vant molecular events, demonstrating the added value of DSP. To visualize
the data and to identify outlier responses, we developed an interactive and
comprehensive Shiny/R application (COBRA). To rank patient-individual
drug sensitivities within the cohort, we applied the Jenks natural breaks
classication, a clustering method designed to minimize dierences
within a class and maximize dierences between classes. Striking parallels
between clinical courses and the DSP results were observed in selected
patients, pointing toward potential predictivity of DSP.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 15
Discussion: e next steps include the systematic validation of the plat-
form with clinical outcome data and the development of prospective clin-
ical trials.
Conclusion: Overall, DSP provides added value to molecular data and is
feasible in international multicenter precision oncology programs, such as
INFORM, in clinical real-time.
Indication of source:
(1) Peterziel H et al. Drug sensitivity proling of 3D tumor tissue cultures in the
pediatric precision oncology program INFORM. NPJ Precis Oncol. 2022 Dec
27;6(1):94.
Disclosure Statement: e authors declare the following: O.W. participated in
the advisory boards of Novartis, BMS and Janssen and received research grants
from BVD, Day One erapeutics. e remaining authors declare no competing
interests.
184
Mimetics of Tumor Suppressor Proteins as Novel Drug
Candidates for Personalized Cancer Therapy
Edgar Dahl1,2; Sophia Villwock1,2; Peter Habenberger3; Axel Choidas3;
Danny Jonigk1,2; Michael Rose1,2; Bert Klebl3
1Institute of Pathology, Medical Faculty, RWTH Aachen University, Aachen,
Deutschland
2Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO
ABCD), Aachen, Deutschland
3Lead Discovery Center GmbH (LDC), Dortmund, Deutschland
Background: A novel therapeutic strategy is proposed to target hard-
to-treat (HTT) cancers by exploiting phenotypic mimicry of proteins
encoded by tumor suppressor genes (TSGs), particularly class 2 TSGs (or
C2TSGs) silenced by DNA promoter methylation. In contrast to exist-
ing targeted therapies that rely on drugs targeting driver alterations, this
approach focuses on mimicking the lost tumor suppressor function by
small molecule compounds.
Methods: e proposed approach involves identication of C2TSG
candidates, biological validation of their signicance, and subsequent
high-throughput screening (HTS) for mimetic drug candidates. Our pilot
study focused on dening mimetics for the tumor suppressor protein
SFRP1, a well-known inhibitor of the WNT pathway. Breast cancer cell
lines transfected with the SFRP1 gene or a control vector were used for the
phenotypic assay, and the CellTiter-Glo® Luminescent Cell Viability Assay
was used to determine tumor cell proliferation.
Results: In an HTS of 189,250 compounds, 430 potential SFRP1 mimetic
hits were identied. Secondary assays, including analysis of Wnt pathway
reporter genes, narrowed the hits to 59 compounds. Most candidates cor-
rectly modulate expression of known SFRP1 targets in our system (i.e.
PCDH10 and COL12A1) reecting correct simulation of SFRP1 function
by the candidate mimetic drugs. Several lead mimetics (e.g. LDC066)
downregulate the phosphorylated LRP6 receptor and cyclin D1, key ele-
ments of the Wnt signalling pathway. Lead mimetic compounds are cur-
rently being tested in dierent mouse models.
Discussion: e shi toward personalized targeted therapies has trans-
formed cancer treatment by focusing on actionable genetic alterations.
However, many challenges remain, particularly in cancers such as pan-
creatic and liver cancers. is innovative strategy of tumor suppressor
protein mimetics may represent a promising approach for the treatment
of HTT cancers.
Conclusion: We present a new therapeutic platform for personalized can-
cer medicine based on specic tumor suppressor protein mimetics.
Disclosure Statement: e authors declare the following: Gesellschaer der
Qithera.
514
Scaling access to Precision Oncology in Germany – The AIO
German Transsectoral Exchange Platform (TEAM-D;
AIO-TF-0323)
Sebastian Lange1; Alexander Desuki2; Annalen Bleckmann3,4;
Sonja Loges5; Anke Reinacher-Schick6; C. Benedikt Westphalen7;
Ina Pretzell8
1II. Medizinische Klinik und Poliklinik am Klinikum rechts der Isar, Technische
Universität München, München, Deutschland
2Universitäres Centrum für Tumorerkrankungen (UCT) Mainz,
Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz,
Deutschland
3Westdeutsches Tumorzentrum, Universitätsklinikum Münster, Münster,
Deutschland
4Medizinische Klinik A, Universitätsklinikum Münster, Münster, Deutschland
5Abteilung für Personalisierte Onkologie, Universitätsmedizin Mannheim,
Medizinische Fakultät Mannheim, Universität Heidelberg, Heidelberg,
Deutschland
6Klinik für Hämatologie, Onkologie mit Palliativmedizin, St. Josef-Hospital,
Klinikum der Ruhr Universität, Bochum, Deutschland
7Medizinische Klinik und Poliklinik III und CCC München, Klinikum der
Universität München, LMU München, München, Deutschland
8Westdeutsches Tumorzentrum, Universitätsklinikum Essen, Essen, Deutschland
Background: e impact of precision oncology has increased over the past
decade. However, extensive molecular proling has unveiled numerous
genomic alterations with therapeutic impact but without approved treat-
ments. is has prompted the establishment of multidisciplinary molec-
ular tumor boards (MTBs) to interpret these alterations. In Germany,
several initiatives aim to integrate precision oncology into routine patient
care. However, exchange on daily practice in precision oncology across
dierent healthcare sectors needs strengthening. e positive Bavarian
cross-site MTB experiences within the Bavarian Cancer Research Center
resulted in the concept of a national, transsectoral, low-threshold peer
exchange platform.
Methods: e virtual Transsectoral German Peer Exchange Platform
(TEAM-D) is an AIO project (Arbeitsgemeinscha Internistische
Onkologie; #AIO-TF-0323) and oers multidisciplinary exchange on
complex clinical questions in German MTBs. e platform was promoted
through various professional channels, including the AIO network, and
presented to DNPM (German Network for personalized medicine) and
BNHO (Professional Association of German Practicing Physicians for
Hematology and Oncology) members. Focusing on specic genomic
alterations in 90-minute sessions, TEAM-D aims to gather, assess, and
publish discussions, recommendations, and case reports, thereby contrib-
uting to evidence generation and harmonizing precision oncology.
Result: Results of the discussions and polls from the rst four meetings
addressing (i) PIK3CA, (ii) AKT/ mTOR/ PTEN, (iii) BRCA, and (iv)
non-BRCA HRD (held July - December 2023), will be presented at the
meeting.
Discussion: e rst case discussions received ample interest with >40
participants from >20 university and community hospitals and pro-
vided important insights into the practice of German precision oncology
programs.
Conclusion: TEAM-D oers a transsectoral peer exchange platform for
recurring questions in German MTBs.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts16
800
Improved Tumor Cell Killing by Combining iiT8 Eector Cells
and Bispecifc EGFRxNKp30 Engagers
Hannes Forkel1; Maren Depke1; Sascha Troschke-Meurer2; Ammelie Svea
Boje3; Katja Klausz3; Lukas Pekar4; Stefan Zielonka4; Christian Andreas
Schmidt1; Matthias Peipp3; Piotr Grabarczyk1
1Universitätsmedizin Greifswald, Comprehensive cancer center MV, Greifswald,
Deutschland
2Universitätsmedizin Greifswald, Department of pediatric hematology and
oncology, Greifswald, Deutschland
3Universitätsklinikum Schleswig-Holstein, Department of Medicine II, Division
of Antibody-Based Immunotherapy, Kiel, Deutschland
4Protein Engineering and Antibody Technologies Merck Healthcare KGaA,
Darmstadt, Deutschland
Background: Loss of BCL11B in human CD8+ T cells leads to the forma-
tion of highly cytotoxic induced innate CD8+ T (iiT8). e development
of bispecic T cell engagers opened the door to an improved engagement
of eector cells like the iiT8 cells to the target tumor cells.
Methods: Human peripheral blood alpha-beta CD8+ T cells were isolated
from buy coats of healthy donors using magnetic separation and knock-
out of BCL11B was induced using the CRISPR/Cas9 system. Eector
cell-mediated killing using NKp30xEGFR engagers against A549 lung
carcinoma spheroids or LAN-1 neuroblastoma spheroids was measured.
Result: Combination of iiT8 cells with EGFRxNKp30 bispecic engager
led to higher lysis of A549 or LAN-1 target cells compared to negative
control antibody or Cetuximab. Presence or absence of a functional
non-mutated Fc-domain of the engager did not inuence cytotoxic activ-
ity, likely due to low FcgRIIIa expression levels on iiT8 cells.
Discussion: e iiT8 cells are characterized by high spontaneous cyto-
toxicity mediated by the NKp30 B7H6 axis, but show reduced anti-tumor
activity if stress ligands are missing on the target cells. Addition of the
bispecic EGFRxNKp30 engager utilized the high surface expression of
NKp30 on the iiT8 cells and enabled cytotoxic activity against tumor cells
expressing low amounts of stress ligand B7H6 but are positive for EGFR.
Conclusion: Combinatory application of iiT8 cells and bispecic engag-
ers represents a promising tool for a variety of anti-cancer therapies by
adding adaptable specicity via bispecic engager to highly cytotoxic iiT8
eectorcells.
Disclosure Statement: e authors declare the following: S.Z and L.P. are
employees of Merck Healthcare KGaA Darmstadt.
Onkologische Pege
151
Standardized nursing consultation for patients with breast
and ovarian cancer under treatment with oral tumor therapy
in gynecological oncology: Evaluation of an interprofessional
webinar within the prospective CAMPA initiative
Franziska Henze1; Lisa Hirschberg1; Sophie Winkler1; Valeria Milani2;
Timo Schinköthe3,4; Renate Haidinger5; Kerstin Paradies6; Sven Mahner1;
Fabian Trillsch1; Nadia Harbeck1; Rachel Würstlein1
1Breast Center, Dept of Gynecology and Obstetrics and CCC Munich, LMU
University Hospital, LMU Munich, München, Deutschland
2Facharztzentrum Fürstenfeldbruck, Fürstenfeldbruck, Deutschland
3CANKADO GmbH, Ottobrunn, Deutschland
4Research Center Smart Digital Health, University of the Bundeswehr Munich,
München, Deutschland
5Brustkrebs Deutschland e.V., Hohenbrunn, Deutschland
6Konferenz Onkologischer Kranken- und Kinderkrankenpege (KOK) in der
Deutschen Krebsgesellschaft e.V., Hamburg, Deutschland
Background: e increase of oral tumor therapy (OTT) presents new
challenges for patient care. Within CAMPA (Care improvement for met-
astatic breast and ovarian cancer patients treated with PARP-inhibitors),
a complementary nursing consultation for patients treated with PARP-
inhibitors is evaluated and information material as well as training for
nurses are implemented.
Methods: Since 02/22, quality of life (QoL), adherence, and adverse
events (AEs) have been evaluated in the oral gynecooncological setting
including standardized nursing support and using questionnaires and
CANKADO-ePRO. Satisfaction with care has been recorded since 03/23.
A specic webinar was developed in the setting of nursing consultation.
Questionnaires are used to track gain of knowledge through nursing
trainings (07-09/23). A total of 1300 participants have been invited for
evaluation of the webinar.
Result: e patient population (n=50) includes 45 patients with ovarian and
5 with breast cancer, receiving special nursing support. At the beginning of
the OTT, patients rate their QoL with approximately 4.2 out of 7 points. In
the further course, QoL increases to 5.8 points. With an average of 4.95 out
of 5 points, satisfaction with CAMPA care is very high. In the webinar, these
results, information material and content on how to conduct and optimize
nursing consultation are explained. Evaluation data will be presented.
Discussion: e large decline in AEs by 66% aer the rst three months
of therapy is highly relevant for the improvement of QoL by 40% in oral
gyneco-oncological treatment. ere is great potential in complementary
nursing support through adequate management of these AEs and adher-
ence to adjuvant, metastatic and/or maintenance therapy.
Conclusion: Especially in the rst months of OTT, intensied care is
essential for QoL, adherence and management of AEs. Standardized nurs-
ing training and consultation is an important contribution to the increas-
ing number of oncological patients under oral therapy and for this aim an
interprofessional webinar represents a highly appreciated tool.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
Psychooncology
168
Beating Cancer-Related Fatigue with the Untire App:
ARandomized Controlled Trial Assessing Ecacy and
Safety among German Patients with Moderate-to-Severe
Cancer-Related Fatigue
Simon Spahrkäs1; Katharina Abraham2; Fatemeh Akbari1; Hp Zenner3;
Bram Kuiper1; Hans Reitsma2; Ewoud Schuit2
1Tired of Cancer, Utrecht, Niederlande
2THINC. The Healthcare Innovation Center, Utrecht, Niederlande
3HNO-Privatpraxis Tübingen | Prof. Dr. H. P. Zenner, Tübingen, Deutschland
Background: is RCT examined the clinical ecacy and safety of the
German language version of the Untire app digital health application (i.e.,
DiGA) in reducing fatigue and enhancing quality of life among cancer
patients. e hypothesis was that supplementing care-as-usual with the
app access would yield superior outcomes for patients suering from
moderate to severe fatigue over 12 weeks.
Methods: Patients with moderate to severe cancer-related fatigue (CRF)
were recruited via newspaper and social media advertisements through-
out Germany and randomized (1:1) to care-as-usual (n=111) or care-
as-usual plus Untire app (n=104). Baseline, 4, 8, and 12-week assessments
included fatigue, quality of life, stress, depression, and anxiety. Linear
mixed models ANCOVAs examined 12-week treatment eects, adjusting
for baseline values within intention-to-treat.
Results: By week 12, the intervention group showed signicantly reduced
fatigue (p=0.0016, d = 0.47), exceeding the clinically relevant minimal
clinically important dierence (MCID: -0.57). Disease-related quality of
life also signicantly improved (p=0.0178, d = 0.35). Subgroup and sensi-
tivity analyses supported consistent treatment eects and robustness.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 17
Discussion: is study conrms the German Untire apps ecacy and
safety in reducing fatigue and improving quality of life among cancer
patients and survivors with moderate to severe fatigue. Subgroup analy-
ses indicate consistent treatment eects regardless of app engagement or
demographic characteristics.
Conclusion: e German Untire app proves eective and safe for moder-
ate to severe cancer-related fatigue.
Disclosure Statement: e authors declare the following: Spahrkäs, Akbarim and
Kuiper are employed by Tired of Cancer.
Sarcoma
825
Are treatment delays associated with a worse outcome in
patient with high-grade osteosarcoma? A retrospective
analysis of data from the EURAMOS-1 trial
Dimosthenis Andreou1; Stefanie Hecker-Nolting2; Daniel Baumhoer3;
Leo Kager4; Matthias Kevric2; Thomas Kühne5; Andreas Leithner1;
Benjamin Sorg2; Per-Ulf Tunn6; Reinhard Windhager7; Stefan Bielack2
1Medizinische Universität Graz, Graz, Österreich
2Klinikum Stuttgart - Olgahospital, Stuttgart, Deutschland
3Universitätsspital Basel, Basel, Schweiz
4St. Anna Kinderspital, Wien, Österreich
5UKBB - Universitäts-Kinderspital beider Basel, Basel, Schweiz
6Helios Klinikum Berlin-Buch, Berlin, Deutschland
7Medizinische Universität Wien, Wien, Österreich
Background: e logistics of multidisciplinary treatment of high-grade
osteosarcoma may sometimes lead to treatment delays. e aim of this
study was to evaluate the impact of such delays on patient prognosis.
Methods: Data from 1671 patients with localized, high-grade osteosarcoma
recruited in the EURAMOS-1 trial (NCT00134030) and undergoing sur-
gical treatment aer induction chemotherapy were analyzed. e optimal
cut-o values for survival analyses were calculated with receiver operating
characteristics curves. Hazard ratios (HR) were estimated with their respec-
tive 95% condence intervals (CI) in multivariate Cox regression models.
Result: e median duration of symptoms amounted to 8 (interquartile
range (IQR), 4-13) weeks, while the median interval between the begin-
ning of induction chemotherapy and surgery was 82 (IQR, 76-90) days.
e median time between surgery and the beginning of consolidation
chemotherapy was 19 (IQR, 14-24) days. A longer duration of symptoms
was associated with a higher tumor volume at diagnosis (234ml vs. 134ml,
p=0.003), but not with a higher risk for death (HR 1.43, 95%CI 0.82-2.49;
p=0.212). On the other hand, both delays between the beginning of induc-
tion chemotherapy and surgery (HR 1.87, 95%CI 1.10-3.21; p=0.022)
and delays between surgery and consolidation chemotherapy (HR 1.46,
95%CI 1.02-2.08; p=0.037) were associated with a higher risk for death.
Discussion: Delays during induction chemotherapy and a delayed start
of consolidation chemotherapy aer surgery are independently associated
with a poorer survival in patients with localized osteosarcoma.
Conclusion: Our results underscore the need to optimize referral path-
ways between dierent departments and hospitals in order to avoid
unnecessary treatment delays.
Disclosure Statement: e authors declare no conict of interest.
Supportive Care
240
Results of the module physical activity in the CARE for CAYA
program - a need-based multimodal lifestyle survivorship
program focusing on physical activity, nutritional behavior
and psychological processes in survivors of cancer in
childhood, adolescence and young adulthood
Simon Elmers1; Julia von Grundherr1; Gabriele Calaminus2; Sonja
Schuster3; Annette Sander4; Alexander Puzik5; Inken Hilgendorf6; Judith
Gebauer7; Michael Köhler8; Jörg Faber9; Nicole Salzmann10; Magdalena
Sokalska-Duhme11; Ronja Beller12; Anne Kollikowski13; Luzia Valentini14;
Freerk T. Baumann15; Eik Vettorazzi1; Wiebke Jensen1; Jannike Salchow1;
Sarah Dwinger1; Alexander Stein1; Carsten Bokemeyer1; Marianne Sinn1
1Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
2UKB Universitätsklinikum Bonn, Bonn, Deutschland
3Kinder- und Jugendklinik, Erlangen, Deutschland
4Medizinische Hochschule Hannover Klinik für Pädiatrische Kardiologie und
Intensivmedizin, Hannover, Deutschland
5Medizinische Fakultät der Albert-Ludwigs-Universität Freiburg, Freiburg im
Breisgau, Deutschland
6Universitätsklinikum Jena, Jena, Deutschland
7Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
8Universitätsklinikum Magdeburg, Magdeburg, Deutschland
9Universitätsmedizin Mainz, Mainz, Deutschland
10Klinik für Kinder- und Jugendmedizin - Pädiatrische Hämatologie und
Onkologie, Münster, Deutschland
11Olgahospital und Frauenklinik | Klinikum Stuttgart, Stuttgart, Deutschland
12Universitätsklinikum Essen, Essen, Deutschland
13CCC Comprehensive Cancer Center Mainfranken, Würzburg, Deutschland
14Hochschule Neubrandenburg, Neubrandenburg, Deutschland
15Uniklinik Köln, Köln, Deutschland
Background: Late and long-term eects oen occur aer a cancer diag-
nosis in childhood, adolescence or young adulthood (CAYA). A healthy
lifestyle and regular physical activity (PA) can reduce the risk of these
sequelae. To improve the PA behavior of CAYAs, a PA-associated module
was developed within the multicenter CARE for CAYA program (CFC-P).
Methods: e CFC-P included comprehensive assessment to determine
initial ‘high need’ (T1). CAYAs could participate in up to three modules
(Psycho-oncology, Nutrition, PA) over 52 weeks (T3). In module PA,
the intervention group (IG) received up to ve counselling sessions as
well as nine newsletters while the control group (CG) received only one
counselling session. All participants received guideline-based motivation
via counselling to adopt a more active lifestyle and body measurements.
Primary endpoint was dened as an increase in PA (BSA-questionnaire
and accelerometry via ActiGraph wGT3X-BT). Secondary endpoints were
self-reported PA, reduction in exercise-related barriers, improvement in
quality of life (QoL) and fatigue.
Result: A total of 357 CAYAs participated at 14 survivorship clinics in
Germany as part of the RCT, of whom 63.0% (n=226) were female. Median
age was 25.0 years and median time since diagnosis was 60 months. e
‘high need’ in PA was 53.3% (IG = 97, CG = 89) at T1 and 45.7% (IG =
67, CG = 56) at T3. Modular endpoints were assessed on an exploratory
basis. Both groups improved their weekly mean leisure-time activities in
minutes (IG: T1 = 250, T3 = 320; CG: T1 = 250, T3 = 270), but neither PA
for sports purposes nor total activity or number of steps improved. QoL
and fatigue improved in both groups with no dierences between groups.
Conclusion: e CFC-P has shown a high demand in multimodal sup-
port among CAYAs, also in the area of PA. One-o professional counsel-
ling on PA as part of regular support for CAYAs seems reasonable. e
additional counseling should be combined with guided, practical exercise
sessions and measurements over a dened period of time in order to be
able to achieve further positive eects.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts18
Disclosure Statement: e authors declare the following: AOK Germany, Astra
Zeneca, Bayer Healthcare, BioNTech, Bristol Myers Squipp, Jansen Cilag, med update,
Merck Serono, On-cology Drug Consult CRO, Roche Pharma, Sano Aventis,
Hamburg Cancer Society, National Network of German Cancer Cen-ters, Northern
German Society of Internal Medicine, DGHO, BeiGene, Janssen-Ciliag, medac,
Celgene, JazzPharmazeuticals, Fondazione Internationale Menarini, BMS, MSD,
Incyte, Pzer, Servier, Amgen, Incyte, Pierre Fabre, Biegene, AbbVie, Novartis.
429
The metabolite prole of extracellular vesicles reects the
nutritional status of lung cancer patients
Said Naser; Matthias Schulz; Judith Büntzel
Klinik für Hämatologie und Medizinische Onkologie, Universitätsmedizin
Göttingen, Göttingen, Deutschland
Introduction: Extracellular vesicles (EVs) are small, membrane-bound
structures released by cells into the extracellular space, oering valuable
insights into the metabolite prole of their parent cells. Secreted into the
blood, they are also available for diagnostics. Cachexia, a frequent occur-
rence among cancer patients (CP), signicantly aects both treatment-
related toxicity and overall survival. Despite this, an eective blood marker
for identifying cachexia has not been identied yet. is study investigates
dierences in the metabolite prole of patients with stable weight (SW)
and with weight loss (WL).
Methods: EVs were isolated by dierential centrifugation from the
peripheral blood of SW and WL patients. Targeted mass spectrometry
was performed using the MxP Quant 500 Kit on an LC-QTRAP 5500
mass spectrometer. Patient records provided data on weight development
(time of sample collection and six months later). Weight loss exceeding
5% within six months was deemed clinically relevant. e open soware
MetaboAnalyst was used for data analysis. Signicant metabolite alter-
ations were identied using volcano plot analysis. Primary component
analysis and heat-map were used for comparisons.
Results: A dataset of 45 CP was analysed. Volcano plot analysis yielded
ve signicant (p < 0.05) metabolites. Amongst those were three metabo-
lites upregulated in WL - triacylglycerols (TG (20:0_34:1) and diacylglyc-
erols (DG (18:0_20:0), DG (18:1_22:6)). Additionally, two downregulated
phosphatidylcholines were found (PC ae C34:2, PC ae C36:3). However,
primary component analysis was unable to distinguish between the two
groups.
Discussion: Metabolic changes manifest at the time of blood collection,
predating the onset of weight loss. is underscores the existence of a
cancer cachexia metabolome. To solidify lipids as biomarkers for cancer
cachexia, extensive cohorts are needed for validation.
Conclusion: Metabolic proling might be a good biomarker to anticipate
weight loss in CP.
Disclosure Statement: e authors declare no conict of interest.
813
Enhancing Patient Activation: Eects of an interprofessional
counseling program on complementary and integrative
health care (CIH) at Comprehensive Cancer Centers
(CCC-Integrativ study)
Jan Valentini1; Daniela Fröhlich1; Inka Rösel1,2; Regina Stolz1; Cornelia
Mahler3; Peter Martus2; Nadja Klafke4; Markus Horneber5; Claudia Witte6;
Klaus Kramer7; Christine Greil8; Barbara Grün9; Katrin Tomaschko10;
Stefanie Joos1
1Institute for General Practice and Interprofessional Care, University Hospital
and Faculty of Medicine Tuebingen, Tübingen, Deutschland
2Institute for Clinical Epidemiology and Applied Biostatistics, University Hospital
and Faculty of Medicine Tuebingen, Tübingen, Deutschland
3Department of Nursing Science, Institute for Health Sciences, University
Hospital and Faculty of Medicine Tuebingen, Tuebingen, Tübingen, Deutschland
4Department of General Practice and Health Services Research, University
Hospital Heidelberg, Heidelberg, Deutschland
5Department of Internal Medicine, Division of Pneumology, Paracelsus Medical
University, Klinikum Nuernberg, Nürnberg, Deutschland
6aQua Institute for Applied Quality Improvement and Research in Health Care,
Goettingen, Göttingen, Deutschland
7Department of Integrative Medicine, University Hospital and Faculty of
Medicine Ulm, Ulm, Deutschland
8Department of Medicine I, Medical Centre University of Freiburg, Faculty of
Medicine, University of Freiburg, Freiburg, Deutschland
9Department of Medical Oncology, National Centre for Tumor Diseases,
Heidelberg, Deutschland
10AOK Baden-Württemberg Hauptverwaltung, Fachbereich Integriertes
Leistungsmanagement, Stuttgart, Stuttgart, Deutschland
Background: Complementary and integrative healthcare (CIH) oers the
chance to empower and activate cancer patients. Studies have shown that
higher patient activation is positively associated with improved quality
of life, better health outcomes and reduced healthcare costs. e CCC-
Integrativ study aimed to assess the implementation of an evidence-based
counseling program on CIH at four Comprehensive Cancer Centers
(CCC) in Baden-Wuerttemberg, Germany.
Methods: In this controlled implementation study, the patient-level
intervention included three CIH consultations within a 3-month period
delivered by specically trained, interprofessional teams of physicians and
nurses. Data collection took place at baseline (T1) and post- intervention
(T2). e primary endpoint was patient activation measured by PAM-13
at T2. Secondary endpoints included e.g. quality of life (EQ 5D) and self-
ecacy (SES6G), were compared between control (CO, receiving routine
care) and the intervention group (IG).
Result: A total of n=1,128 oncology patients (CO=443, IG=685) with
diverse tumor entities and cancer stages were included in the study.
e overall mean baseline PAM-13 score was 69.74 (SD=14.24) (n=959
(85.0%)). A statistically signicant between-group dierence in post-
intervention PAM-13 scores was observed (Fgroup(1, 1866.82)=8.634,
p=0.003), with an adjusted mean dierence of 2.22 PAM-points.
Analyses of secondary outcomes and health economic evaluations will
be reported.
Discussion: To the best of our knowledge, the CCC-Integrativ Study rep-
resents the largest cohort of cancer patients examined with PAM-13 in a
pre-post design to date. e new healthcare approach leads to a signi-
cantly higher level of patient activation compared to the CO.
Conclusion: Individually tailored counseling on CIH, oered by spe-
cically trained, interprofessional teams, signicantly improved patient
activation. e implementation of such a counseling program at cancer
centers may have benecial eects not only for patients but also for the
healthcare system.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 19
Thoracic Cancer
246
PD-L1 on large extracellular vesicles is a predictive biomarker
for therapy response in tissue PD-L1-low and -negative
patients with non-small cell lung cancer
Marcel Kemper1; Nadja Schöne1; Kerstin Menck1; Georg Evers1;
Carolin Krekeler1; Arik Bernard Schulze1; Georg Lenz1; Eva Wardelmann2;
Claudia Binder3; Annalen Bleckmann1
1Medizinische Klinik A, Universitätsklinikum Münster, Albert-Schweitzer-
Campus 1, Münster, Deutschland
2Universitätsklinikum Münster - Institut für Pathologie, Münster, Deutschland
3Klinik für Hämatologie und Medizinische Onkologie - Universitätsmedizin
Göttingen, Göttingen, Deutschland
Background: Tissue PD-L1 expression (tPD-L1) is currently the only
existing biomarker that positively correlates with the probability of
response to immune-checkpoint inhibitors (ICI) in patients with non-
small cell lung cancer (NSCLC). However, the predictive power of tPD-
L1 is limited, in particular in patients with low, or absent, tPD-L1. is
study tested whether extracellular vesicles (EVs) in plasma could be used
as novel predictive biomarkers in liquid biopsies for the response to ICI.
Methods: We isolated large EVs (lEVs) from NSCLC cell culture
supernatants as well as from peripheral blood of NSCLC patients
(n=108), non-cancer (n=23) and healthy (n=54) controls by dierential
ultracentrifugation. lEVs were characterized by electron microscopy,
nanoparticle tracking analysis, and immunoblot. Antigen expression on
patient-derived lEVs at baseline was measured by ow cytometry and
results were correlated with clinical data, including response to ICI-
containing therapy aer 3 and 6 months.
Result: We identied a panel of NSCLC-related antigens that were enriched
on lEVs from NSCLC cell lines. e levels of lEVs carrying these antigens
were elevated in plasma of NSCLC patients, discriminated them from controls
and had a prognostic value for patient survival. Among the antigens, PD-L1
showed the most striking increase and was mainly found on CD45/CD62P
lEVs. Patients with high levels of PD-L1+ lEVs showed a signicantly better
response to therapy, including ICI, and prolonged survival. is was particu-
larly true for the subgroup of patients with low or absent tPD-L1 expression.
Discussion: e predictive value of PD-L1+ lEVs at baseline outper-
formed tPD-L1. As cancer cells can export PD-L1 onto EVs, they might
better reect tumor heterogeneity and PD-L1 expression than the tPD-
L1 status. However, the origin of the PD-L1+ lEVs in plasma currently
remains elusive.
Conclusion: PD-L1+ lEVs are a novel predictive and prognostic bio-
marker for response to ICI in NSCLC that is superior to the standard-of-
care measurement of tPD-L1.
Disclosure Statement: e authors declare the following: is project was funded
by the Deutsche Forschungsgemeinscha (DFG, German Research Foundation -
project 424252458), the Else Kröner-Fresenius-Stiung (project 2019_A162), the
innovative medical research (IMF) of the Medical Faculty, University of Münster
(project ME 12 19 14), and Novartis (InCa Förderpre-is 2021).
Poster
Articial Intelligence in Cancer Care and
Diagnostics
75
Navigating Complexity in Radiation Therapy: Data Mining
and Large Language Models as Key Tools
Maximilian Grohmann; Cordula Petersen; Andrea Baehr
Universitätsklinikum Hamburg-Eppendorf, Klinik für Strahlentherapie und
Radioonkologie, Hamburg, Deutschland
Background: e ability to eciently analyze and structure this data
could lead to signicant improvements in radiation therapy planning and
personalization. However, analyzing and structuring radiation planning
data can be challenging due to its complexity and diversity.
Methods: We collected a year’s worth of radiation treatment data using a data
mining script through a Treatment Planning Soware application program-
ming interface. is data was subsequently analyzed and restructured using a
ne-tuned version of the Large Language Model (LLM) LLAMA2. e data-
set included a wide range of parameters, such as patient demographics, treat-
ment plan details, scheduled appointments, and medical history.
Results: We collected a year’s worth of radiation treatment data using a
custom-programmed data mining script to search through the database.
e LLAMA2 model identied patterns linking radiation doses or tech-
niques to patient reactions, assisting in treatment outcome predictions.
It also suggested renements to treatment plans drawn from similar
patient proles, enhancing planning eciency and quality. Additionally,
the model made predictions about specic side eects for patient subsets
using treatment protocols and histories.
Discussion: Utilizing AI models like LLMs in radiation data analysis
oers a transformative approach to enhance and personalize radiation
therapy planning. e LLAMA2 models capability to discern intricate
patterns showcases its utility in optimizing treatment strategies. While its
potential is evident, further research is paramount to validate its full eec-
tiveness and clinical relevance.
Conclusion: Our research highlights the profound impact of AI-driven
tools, specically the ne-tuned LLAMA2 model, on radiation treatment
data analysis. rough this approach, therapy planning becomes more tar-
geted and adaptable. Moreover, the methodologies and insights obtained
can be extended to other medical disciplines.
Disclosure Statement: e authors declare no conict of interest.
452
ChatGPT’s Performance in German OB/GYN Exams – Paving
the Way for AI-Enhanced Clinical Care
Maximilian Riedel1, Katharina Känger1, Antonia Stuehrenberg1,
Viktoria Ritter1, Niklas Amann2, Anna Graf 1, Florian Recker3, Evelyn Klein1,
Marion Kiechle1, Fabian Riedel4, Bastian Meyer1
1Frauenklinik Klinikum rechts der Isar, TU München, München, Deutschland
2Frauenklinik Friedrich–Alexander-Universität Erlangen–Nürnberg, Erlangen,
Deutschland
3Frauenklinik Universitätsklinikum Bonn, Bonn, Deutschland
4Frauenklinik Universitätsklinikum Heidelberg, Heidelberg, Deutschland
Background: Chat Generative Pre-Trained Transformer (ChatGPT) is an
articial learning and large language model tool developed by OpenAI
in 2022. Our study aimed to assess ChatGPT’s performance in medical
knowledge competency – particularly for problem assessment in obstet-
rics and gynecology (OB/GYN) – and to discuss possible applications.
Methods: For the analysis, two datasets were established: questions (1)
from OB/GYN course exams at a German university hospital and (2)
from the German medical state licensing exams. A quantitative analysis
compared the accuracy of ChatGPT’s answers with that of medical stu-
dents for dierent levels of diculty and types of questions. Additionally,
a qualitative analysis assessed the quality of ChatGPT’s responses. Non-
obvious insights generated by ChatGPT were evaluated, and a density
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts20
index of insights was established in order to quantify the tool’s ability to
provide relevant medical knowledge.
Result: ChatGPT demonstrated consistent performance across both data-
sets. It provided correct responses at a rate comparable with that of medical
students, thereby indicating its ability to handle a diverse spectrum of ques-
tions ranging from general knowledge to complex clinical case presenta-
tions. Our qualitative assessment revealed that ChatGPT provided mostly
accurate, complete, and relevant answers. ChatGPT additionally provided
many non-obvious insights, especially in correctly answered questions, which
indicates its potential for enhancing autonomous medical learning.
Discussion: ChatGPT has promise as a supplementary tool in medical
education. As AI technologies continue to evolve, ChatGPT and similar
tools may contribute to more ecient and personalized learning experi-
ences, thereby fostering inclusivity and accessibility.
Conclusion: ChatGPT’s ability to provide accurate and insightful
responses showcases its adaptability to complex clinical scenarios. is
may pave its way for further application in the clinical setting, for example
in clinical oncology.
Disclosure Statement: e authors declare no conict of interest.
462
KITTU: Articial intelligence supports multidisciplinary cancer
conferences – rst steps towards revolutionizing clinical
decision making in oncology
Gregor Duwe1; Verena Kauth1; Kerstin Moench1; Dominique Mercier2;
Markus Junker2; Juergen Scheele3; Werner Seiz3; Oliver Pfante3;
Juan Pablo Vesga Simmins3; Natasja De Bruin3; Axel Haferkamp1;
Andreas Dengel2; Thomas Höfner1,4
1Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und
Poliklinik für Urologie und Kinderurologie, Mainz, Deutschland
2Deutsches Forschungszentrum für künstliche Intelligenz GmbH - Zentrale,
Smarte Daten & Wissensdienste, Kaiserslautern, Deutschland
3Innoplexus AG, Translational Science, Eschborn, Deutschland
4Ordensklinikum Linz Elisabethinen, Klinik für Urologie, Linz, Österreich
Background: Decisions on the best available treatment in clinical oncol-
ogy are based on expert opinions in multidisciplinary cancer conferences
(MCC). e experts should provide unbiased recommendations based on
current guidelines and clinical studies. For this purpose, articial intelli-
gence (AI) could increase evidence-based treatment in oncology as assis-
tance system to give an additional treatment recommendation in MCC.
Methods: We have dened consecutive work steps to achieve this goal.
As a st step, we have transformed patient data of our urological MCCs
from 2015 - 2022 into representations that can be used in soware devel-
opment. Additionally, we have transformed relevant data from clinical
studies selected knowledge representation. Currently, soware routine
and rst AI neural network soware is developed.
Results: e collaborative project has successfully applied for a grant of 2.4
million euros from the German Federal Ministry of Education and Research
(BMBF, grant number: 16SV9053) to conduct this multidisciplinary research
together with international experts in AI development. KITTU will run from
August 2022 until July 2025. If the results of our dened working packages
are successful, we will start the technical integration into everyday clinical
practice based on a subsequent soware development study.
Discussion: With our alliance project “KITTU” (AI-supported treatment
support for cancer patients in urology) we aim to develop a pioneering AI
assistance system to generate additional treatment recommendations in
MCC. By the inclusion of study results within the machine learning pro-
cess we expect to provide an AI system that is explainable in its decisions
to support individual treatment decisions.
Conclusions: KITTU will be developed to support clinical decision mak-
ing in clinical oncology, beginning in genitourinary cancer. If successful, it
would revolutionize integration of knowledge from AI into genitourinary
oncology and could potentially be transferred to all types of oncological
treatments.
Disclosure Statement: e authors declare no conict of interest.
506
Exploring the potential of AI-powered applications for clinical
decision-making in gynecology
Bastian Meyer1; Katharina Känger1; Niklas Amann2; Florian Recker3;
Evelyn Klein1; Marion Kiechle1; Fabian Riedel4; Maximilian Riedel1
1Klinikum rechts der Isar, TU München, München, Deutschland
2Frauenklinik Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen,
Deutschland
3Frauenklinik Universitätsklinikum Bonn, Bonn, Deutschland
4Frauenklinik Universitätsklinikum Heidelberg, Heidelberg, Deutschland
Background: e rise of AI-powered platforms like ChatGPT heralds a
promising phase in medical innovation. Exhibiting remarkable prowess
in medical assessments, oen surpassing the performance of medical
students, these platforms oer considerable promise for revolutionary
applications in healthcare. is study seeks to investigate the viability of
employing ChatGPT for automated therapy recommendations by exam-
ining patient data, specically within the domain of gynecology.
Methods: Utilizing datasets comprising random patient information from
a university gynecological outpatient clinic and diverse scenarios from
gynecological tumor boards, we tasked ChatGPT with automated diagno-
sis and treatment suggestions. Expert gynecologists rigorously evaluated
the generated responses both qualitatively and quantitatively, comparing
them against actual clinical decisions.
Result: In the majority of outpatient scenarios, ChatGPT’s diagnoses were
in close agreement with clinical assessments, and the suggested therapies
received highly positive evaluations. Particularly noteworthy was the consen-
sus reached in therapeutic recommendations for both gynecological and seno-
logical cases presented in the context of tumor board scenarios. Nevertheless,
no additional benet was evident in relation to study inclusion, given that the
platforms dataset was conned to information accessible until 2021.
Discussion: Our study extends upon existing knowledge of utilizing
AI-based applications such as ChatGPT in the eld of medicine. While
therapy recommendations for outpatient cases received favorable reviews,
the diverse results in tumor board scenarios reect the real-world intri-
cacies that demand discussions involving multiple experts. We highlight
both the advantages and constraints of the application in its present form.
Conclusion: Envisioning the ongoing incorporation of AI-powered solu-
tions in the medical realm, we foresee the potential for automated therapy
recommendations to support human clinical decisions in the future.
Disclosure Statement: e authors declare no conict of interest.
541
Feasibility of AI-based optimization of patient-physician
conversations
Chloë Goossens1,2,3; Lena Wurmthaler1,2,3; Lena Brückner1,2,3;
Manuel Hörner1,2,3; Matthias W. Beckmann1,2,3; Frederik Stuebs1,2,3;
Anna Lisa Zahn1,2,3; Peter Andreas Fasching1,2,3; Hanna Hübner1,2,3
1Bavarian Cancer Research Center (BZKF), Erlangen, Deutschland
2Department of Gynecology and Obstetrics, University Hospital Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen,
Deutschland
3Comprehensive Cancer Center EMN, University Hospital Erlangen, Friedrich-
Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
Background: Oncologists face the challenge of responding to patient needs
while making therapeutic decisions under time constraints. Patient-physician
communication can aect treatment decisions and patients’ quality of life.
Articial intelligence (AI) could help optimize individual patient-physician
communications and might aid medical decision-making.
Methods: Conversations between oncologists and breast cancer patients
were recorded, transcribed and evaluated by ChatGPT (language model
based on GPT-3.5 architecture by OpenAI) using 19 structured questions.
Questionnaires assessed the feasibility of recordings and acceptance of
AI-based conversation optimization and medical decision-making.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 21
Result: Between May 2021 and May 2023, 68 patients were enrolled in the
COMMITMENT study. 56 of 59 audio recordings were successfully tran-
scribed and 52 transcripts evaluated by ChatGPT. According to ChatGPT,
30 conversations (58%) could have been improved if the physician and
patient provided more specic information on symptoms and medication.
14 patients (27%) reported side eects when rst asked, while 16 patient
responses (31%) were deemed somewhat to moderately specic. Other
optimizable aspects included actively addressing patient concerns (56%;
N=29) and encouraging patient engagement (50%; N=26). 53 patients
(86%) found audio recording acceptable. 53% (N=33) agreed that AI
could make it easier for the physician to show interest in the patients
needs and increase mutual attentiveness (45%; N=28). 43 patients (69%)
found that AI should not replace physicians in medical decision-making
and 77% (N=48) would always trust physicians over AI.
Discussion: AI identied optimizable aspects in patient-physician con-
versations. Patients perceived AI-based conversation optimization as
favorable and feasible, whereas AI-based medical decision-making was
viewed more critical.
Conclusion: AI-based optimization of patient-physician conversations
appears feasible and should be further investigated.
Disclosure Statement: e authors declare no conict of interest.
581
Krebs-Forschungsdatenzentrum – Konzeption,
Herausforderungen und Analysepotenzial des Linkage
versorgungsnaher Daten –
Olaf Schoer1; Kees Kleihues-van Tol2; Fabian Baum1; Bianca Franke2;
Vinzenz Völkel3; Stefan Rolf Benz4; Judith Hansinger3; Martin Lablans5;
Michael Gerken3; Daniel Maier6; Fabienne Fox6; Melanie Börries7;
Jörg Janne Vehreschild6; Tobias Kussel5; Soo-Zin Kim-Wanner8;
Jacqueline Witzmann2; Monika Klinkhammer-Schalke2,3; Jochen Schmitt1
1TU Dresden - Zentrum für Evidenzbasierte Gesundheitsversorgung (ZEGV),
Dresden, Deutschland
2Arbeitsgemeinschaft Deutscher Tumorzentren e. V., Berlin, Deutschland
3Universität Regensburg, Tumorzentrum Regensburg, Regensburg, Deutschland
4Arbeitsgemeinschaft Deutscher Darmkrebszentren (addz e.V.), Hamburg,
Deutschland
5Deutsches Krebsforschungszentrum (DKfZ), Heidelberg, Deutschland
6Johann Wolfgang Goethe Universität Frankfurt, Med. Klinik, Frankfurt am Main,
Deutschland
7Universitätsklinikum Freiburg, Institut für Medizinische Bioinformation und
Systemmedizin, Freiburg, Deutschland
8HLfGP - Hessisches Krebsregister, Frankfurt am Main, Deutschland
Background: e law on the pooling of cancer registry data denes a
framework for the nationwide synthesis of oncological treatment data.
Leading organizations and representatives of cancer registries are working
together to develop a platform solution. Since randomized controlled tri-
als are not equally suitable for all questions, guidelines for some questions
only contain recommendations with a limited level of evidence. Analyses
of health care data can close gaps and generate high-quality evidence.
erefore, the overall goal of the project Cancer Research Data Center
(onkoFDZ) is the development of an IT infrastructure that enables the
linkage of these data and tests the evidence generation on the basis of the
use case “therapy of colorectal cancer”.
Methods: Data from dierent care-related sources are integrated: Clinical
Cancer Registries (CCR), certied centers of the German Cancer Society
(DKG), German Consortium for Translational Cancer Research (DKTK)
and statutory health insurance (SHI). e data are comprehensively
cleaned, harmonized and linked on an occasion-related basis. Machine
learning (ML) methods will then be used to approximate treatment inten-
tions from documented treatment decisions. In addition, ML methods
will be compared with conventional statistical methods of data analysis.
Result: In the current initial phase of the project, concepts and study
documents for data ows and evaluation are being developed, taking into
account data protection requirements.
Discussion: Linking heterogeneous data from dierent sources is chal-
lenging, as it is subject to strict data protection requirements and requires
comprehensive harmonization.
Conclusion: e IT infrastructure developed in the project as a basis for
linking healthcare-related data from dierent sources will be implemented
sustainably and made available permanently to the scientic community
to enable AI-based generation of high-quality evidence.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
615
Creation of realistic synthetic cancer registry data
Mika Katalinic1; Jan Gaebel2; Matthäus Stöhr3; Martin Schenk4;
Stefan Franke5; Alexander Katalinic6; Thomas Neumuth2; Andreas Dietz3
1Universität Leipzig, Leipzig, Deutschland
2Innovation Center Computer Assisted Surgery (ICCAS), University Leipzig,
Leipzig, Deutschland
3Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum
Leipzig, Leipzig, Deutschland
4Innovation Center Computer Assisted Surgery, University Leipzig, Leipzig,
Deutschland
2Innovation Center Computer Assisted Surgery (ICCAS), University Leipzig,
Leipzig, Deutschland
6Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
Background: Comprehensive cancer registry data has to be evaluated as
personal data, even when no names of patients, address or full birth date
are included. Risk of reidentication of patients by record linkage with other
data sources is high. So, data sharing might not always be possible, especially
when large, open science datasets are needed, as for AI development. For
such purposes synthetic data should be as realistic as possible, e.g., survival
analyses should lead to realistic gures. With our project we aimed to gener-
ate realistic cancer data with the use case of laryngeal cancer.
Methods: We used the open-source soware Synthea and programmed an
additional module for development, treatment and follow-up (5 years) of
laryngeal cancer (ICD 10: C32), using external, real-world (RW) evidence
from guidelines, cancer registries and literature for Germany. To gener-
ate an incidence-based cohort view, we randomly draw laryngeal cancer
cases from the simulated population and deceased persons, stratied by
the real-world age- and sex-distribution of laryngeal cancer at diagnosis.
Result: A Synthea module letting person fall sick with laryngeal cancer,
with age- and stage-specic treatment and prognosis could be successfully
implemented. e synthesized population reects RW prevalence quite
well. Extracting laryngeal cancer patients leads to a cohort of more than
10.000 laryngeal cancer patients. Descriptive data, as well as stage-specic
and overall 5-year survival, was in good agreement to published data.
Discussion: Using synthetic cancer patients, generated by Synthea, will
enable the creation of realistic and large (even larger than RW incidence)
cancer patient cohorts. Such data could be easily shared and published as
open source without any data protection issues.
Conclusion: Using the data for analyses will lead to realistic results,
whereas realism is limited by the amount of information included in the
module.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts22
735
Exploring Data-Based Machine Learning Algorithms for the
Evaluation of Disease Stage, Treatment-response and Overall
Survival in Pancreatic adenocarcinoma
François Schneider1; Haotian Chen2; Richard G. Compton2;
Uwe Pelzer1; Gregor Duwe3; Sebastian Stintzing1; Ulrich Keilholz4;
Christopher Neumann1
1Medizinische Klinik mit Schwerpunkt Onkologie und Hämatologie der Charité
Campus Mitte, Berlin, Deutschland
2Department of Chemistry, Physical and Theoretical Chemistry Laboratory,
Oxford University, Oxford, United Kingdom
3Department of Urology and Pediatric Urology, University Medical Center of the
Johannes-Gutenberg University Mainz, Mainz, Deutschland
4Charité Comprehensive Cancer Center, Berlin, Deutschland
Background: Articial Intelligence (AI) and in particular the eld of
Machine Learning is gaining more and more importance in Medicine and
Clinical Oncology. Data-based AI algorithms can identify unknown cor-
relations of multiparametric matrices and have great potential for devel-
oping novel digital-based predictive and prognostic biomarkers.
Methods: First, we implemented the Random Forest Classier and Gradient
Boosting Classier. In order for these Classies to be trained, we used our
patient database, including all patients diagnosed with PDAC at the Charité
- Universitätsmedizin Berlin between 2009 and 2021. As one of the largest
monocentric databases, this comprised a total of 2.323 patients. e dataset
was randomly divided into a training and applied/tested dataset. By using
trained AI-algorithms to our applied dataset, the accuracy of our models was
evaluated. e results were visualized by ROC curves.
Result: Random Forest and Gradient Boosting Classiers were performed
on our dataset including clinical and laboratory data of patients with
PDAC. Both classiers showed high accuracy in predicting the 3- and
5-year-survival rate (> 84.6%, ROC AUC 0.72). Moreover, AI-algorithms
were able to predict whether PDAC patients were metastasized with an
accuracy as high as 80.3% (ROC AUC 0.76). By implementing a binary
classication of the two chemotherapeutic regimens mFOLFIRINOX vs.
Gemcitabine/nab-Paclitaxel, an accuracy > 80.0% was achieved.
Discussion: e results of this study illustrate that both Random Forest
and Gradient Boosting are eective classiers for predictability power
in Clinical Oncology. Further more complex AI-algorithms will need to
be implemented, not only accounting for the clinicial data but also the
image-analyses of radiological datasets.
Conclusion: e present study contributes to the evaluation of
AI-algorithms for predicting disease stage, treatment-response and
overall survival in PDAC patients.
Disclosure Statement: e authors declare no conict of interest.
758
The modied Polsby-Popper score is a novel quantitative
histomorphology biomarker with potential to predict
lymph node positivity and cancer-specic survival in tongue
squamous cell carcinoma
Tamás Dániel Csűry1,2,3; Anna Zsóa Csűry4; Matthias Balk1,2,3;
Andreas M. Kist5; Robin Rupp1,2,3; Sarina Müller1,2,3; Matti Sievert1,2,3;
Heinrich Iro1,2,3; Markus Eckstein1,3,6; Antoniu-Oreste Gostian1,2,3
1Comprehensive Cancer Center EMN, University Hospital Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
2Department of Otolaryngology, Head & Neck Surgery, University Hospital
Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen,
Deutschland
3Bavarian Cancer Research Center (Bayerisches Zentrum für Krebsforschung,
BZKF), Erlangen, Deutschland
4individual contributor, Mechelen, Belgien
5Department Articial Intelligence in Biomedical Engineering, Friedrich-
Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
6Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-
Universität Erlangen-Nürnberg, Erlangen, Deutschland
Background: e signicance of dierent histological tumor spreading
patterns in tongue squamous cell carcinoma (TSCC) is well known. We
constructed a numeric parameter, i.e. the modied Polsby-Popper (MPP)
score, reecting the aggressiveness of tumor spread to analyze hematoxy-
lin and eosin-stained whole slide images (WSIs) in an automated manner.
We investigated the application of the MPP score in predicting survival
and cervical lymph node metastases as well as in determining patients at
risk in the context of dierent surgical margin scenarios.
Methods: We developed a semi-automated image analysis workow to
detect tumorous areas of the WSIs. Perimeter and area of the detected
regions were derived, and a mathematical formula was applied to reect
the perimeter/area ratio in a comparable manner across WSIs. We
demonstrated the plausibility of the MPP score by correlating it with well-
established pathological parameters. We then performed survival analysis
to assess the relevance of the MPP score with an emphasis on dierent
surgical margin scenarios. Machine learning models were developed to
predict survival and occult cervical metastases.
Results: e MPP score was associated with unfavorable tumor spread.
Higher MPP scores were associated with worse overall survival and tongue
carcinoma-specic survival (TCSS), both when assessing all pT-categories
and pT1-pT2 categories only. Higher MPP scores were associated with
a worse TCSS where a cancer-free surgical margin of <5 mm could be
achieved. e MPP score could successfully dene patients at risk of distant
metastasis in pT1-pT2 cancer. Machine learning (ML) models including the
MPP score could predict the 5-year TCSS eciently and those that predict
occult cervical lymph node disease benetted from including the MPP score.
Conclusion: We introduced an objective and observer-independent
parameter, the MPP score, representing the aggressiveness of tumor
spread in TSCC. We showed its prognostic relevance especially in
pT1-pT2 TSCC and its use in ML models predicting TCSS and occult
cervical metastases.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 23
782
Decipher patient needs in the process of genetic counseling to
individualize the personal assistant GENIE
Beate Vajen1; Nils Ammon1; Chiara Reichert2; Steen Oeltze-Jafra2;
Schlegelberger Brigitte1; Anke Katharina Bergmann1; Thomas Kupka2;
Dominik Wol2
1Medizinische Hochschule Hannover/Institut für Humangenetik, Hannover,
Deutschland
2Medizinische Hochschule Hannover/Peter L. Reichertz Institut für Medizinische
Informatik, Hannover, Deutschland
Background: Genetic counseling is a central element in the care of
patients and families with hereditary breast and ovarian cancer (HBOC).
Index patients and their families receive a wealth of information, about
the nature of the disease, preventive measures, therapy options, support
services such as psycho-oncological care. We develop the mobile assistant
GENIE to support patients in the genetic counseling process in a person-
alized way. For the personalization, we rst determined patient needs with
qualitative interviews.
Methods: To determine patients’ needs, nine qualitative interviews were
conducted in 10/2022 with HBOC patients, who presented for genetic
counseling and testing at the Department of Human Genetics (2017-
2022) of Hanover Medical School. Six women suered from breast cancer
while three women had no cancer diagnosis. e qualitative evaluation
was performed using Mayring’s content analysis.
Result: Although the interpersonal interaction between human geneti-
cists and patients was reported as a positive experience, patients noted
that 1) the timing of counseling was oen inconvenient, 2) a second
genetic counseling would be helpful, 3) there was a need for support in
collecting own and familial medical information before the genetic coun-
seling session, 4) the assistance in contacting self-help groups and psy-
cho-oncologists could be enhanced, 5) the density of medical information
was excessively high.
Discussion: Our ndings reveal a signicant demand among HBOC
patients for improved personalized support. Interestingly, patients
increasingly requested supportive information regarding medical genetics
not only aer genetic counseling but also before it.
Conclusion: e results contribute to the development of a patient-
centered support tool designed to assist patients before and aer genetic
counseling takes place. e implementation of AI-based mobile support
for HBOC patients will improve their self-ecacy and health literacy
while alleviating their burden.
Disclosure Statement: e authors declare no conict of interest.
838
Roboscreen: an automated, multiparameter 3D diagnostic
platform for personalized cancer therapy
Barbara Mayer1; Marlene Niederreiter1; Jan Rael2; Victoria Scharin3;
Marco Flachmann3; Martin Gutbrod4; Petra Mela2
1Department of General, Visceral and Transplantation Surgery, LMU University
Hospital, LMU Munich, München, Deutschland
2Technical University of Munich, München, Deutschland
3Opto GmbH Munich, München, Deutschland
4PreSens Precision Sensing GmbH, Regensburg, Regensburg, Deutschland
Background: Currently, the selection of personalized therapies for indi-
vidual cancer patients is primarily based on single outcome measure-
ments. However, single-assay systems poorly reect the complexity of
tumors, resulting in limited predictive power of drug testing.
Methods: To overcome this obstacle, the Roboscreen project introduced
an automated platform that integrates imaging, sensing, metabolomics,
and machine learning. is multi-parameter system is used for drug
screening in the patient-derived cancer spheroid model (PDCS).
Result: A platform consisting of three interactive units was devel-
oped: automated production of high-content PDCS models, automated
label-free, real-time imaging, and automated high-resolution pH and
O2 sensing. Given these parameters, PDCS can be screened for optimal
treatment time points. e system runs under standardized incubator
conditions.
Discussion: Manual preparation of PDCS models, followed by man-
ual pipetting of drugs and endpoint measurements for drug ecacy, is
a time-consuming, error-prone workow. Integrative automation of this
multi-step process is a prerequisite for standardization, reproducibility,
scalability, and timesaving. Automated drug screening is particularly
advantageous for large tumor samples and high-throughput analyses.
However, in biopsies, tumor material is lost due to machine dead vol-
ume. In addition, dierent processing protocols are required to cope with
tumor heterogeneity and complexity.
Conclusion: e automated, multi-parametric 3D diagnostic platform
is a prerequisite for comprehensive and standardized personalization of
cancer therapy and drug development.
Disclosure Statement: Authors BM, MHN, JP, and PM declare no conict
of interest. Authors MF and VS are employees of Opto GmbH and MG is an
employee of PreSens Precision Sensing GmbH.
Disclosure Statement: e authors declare the following: Firmeninteresse.
851
AI to fully automate detection of tumor budding in head
and neck cancer
Iordanis Ourailidis1,2; Albrecht Stenzinger1; Peter Schirmacher1;
Wilko Weichert3; Fabian Stögbauer3; Melanie Boxberg3; Jan Budczies1
1Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg,
Deutschland
2Faculty of Biosciences, Heidelberg University, Heidelberg, Deutschland
3Institut für Pathologie, Technische Universität München, München,
Deutschland
Background: Tumor budding (TB), referring to clusters of up to four
tumor cells detached from the tumor bulk, is highly prognostic for poor
patient survival and associates with lymph node mestastasis in head and
neck squamous cell carcinoma (HNSCC)1. TB is detected in histopatho-
logical hematoxylin/eosin-stained (HE) slides via a laborious, time con-
suming process. us, it is of great importance to enable a fast, accurate
and standardized way of detection of TB patterns. Achieving this goal can
be mediated by developing an automated method for TB detection.
Methods: 70 randomly selected TCGA HNSCC HE whole-slide images
(WSI) of budding cases were tiled, annotated by pathologists and used
for training and validation (80% and 20% respectively), while 252 TCGA
HNSCC HE WSIs constituted the test dataset (TD). Using YOLOv52, a
single-pass CNN-based object detector, we developed a custom bud
detector for rapid assessment of TB. Our detector’s results were compared
to TB scores obtained by the pathologists1.
Result: e TB estimation of the bud detector and the pathologists are
highly correlating (Pearsons R=0.8, p<10-15, TD). Our detector could sep-
arate the high and low budding cases [with AUC=0.85 (0.8-0.9), p<10-15,
TD] and show that tumor budding leads to worse survival rates [HR=1.6
(1.1-2.3), p<0.02, TD].
Discussion: TB detection methods have been developed for other can-
cer entities, mostly colorectal cancer3. However, to our knowledge this is
the rst fully automated tumor bud detector for HNSCC. Our automated
TB detector can alleviate the prognostic stratication of HNSCC patients,
improving clinical management and follow-up.
Conclusion: We demonstrate that fully automated tumor bud detection
and TB assessment using HE WSIs is feasible in HNSCC, can be achieved
fast with low computational power and facilitates prognostic stratication
of patients. e applicability of our TB detector should be tested in daily
clinical practice.
1. Stögbauer F et al., Br J Cancer. 2023;128(12) 2295.
2. Jocher G, Ultralytics YOLOv5. 7.0, 2020.
3. Bokhorst, JM et al., Mod Pathol. 2023;36(9) 100233.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts24
Disclosure Statement: e authors declare the following: JB and MB: funding by
the German Cancer Aid (grants 70113973 and 70113976). JB: consulting fees by
MSD. MB: consulting fees by BMS. AS: grants by Bayer, BMS, Chugai, and Incyte.
AS: Advisory Boards/Speaker’s Bureau: Agilent, Aignostics, Amgen, Astra Zeneca,
Bayer, BMS, Eli Lilly, Illumina, Incyte, Janssen, MSD, Novartis, Pzer, Qlucore,
Roche, Seagen, Takeda, ermo Fisher. PS: funding by Roche, Chugai, BMS,
Novartis. PS: Advisory Board/Speaker’s Bureau: Astra Zeneca, Incyte, Janssen.
891
When time is of the essence – ethical implications of XAI in
surgical oncology
Andreas Wabro; Markus Herrmann
NCT Heidelberg, Section Translational Medical Ethics, Heidelberg, Deutschland
Purpose: Explainable articial intelligence (XAI) has the potential to pro-
vide valuable intraoperative decision support, likely augmenting surgical
judgment, anticipating adverse events, and facilitating further treatment
planning while retaining trust through transparency. In surgical oncol-
ogy, XAI could improve decision-making by reducing surgery times and
unfavorable outcomes. Despite increasing calls for XAI on regulatory lev-
els, inherent properties of surgical environments, such as time pressure
and economic eciency, are most oen le unnoticed. e aim of this
paper is to discuss the application of XAI in time-sensitive environments
of surgical oncology, and to provide an ethical assessment of clinicians
accountability for their decisions reached.
Methods: We conducted a series of expert interviews with academic
researchers currently in charge of designing XAI decision support sys-
tems. We used a questionnaire created by including relevant aspects of
ethics guidelines provided by supranational institutions.
Results: We identied relevant ethical implications to be further dis-
cussed in the context of surgical oncology. XAI could facilitate intraoper-
ative evaluation of resection margins, predict stitching patterns, and assess
blood perfusion of anastomoses, among other types of benecial appli-
cations. Yet, time-pressure constraints of surgical environments could
essentially deter surgeons to properly consider the respective explanatory
output. Additionally, requiring XAI in time-sensitive environments could
counteract initial reasons for deploying the decision support system at
hand.
Discussion: ese ndings have strong implications regarding the ascrip-
tion of accountability, for psychological traits and time pressure con-
straints could alter the decision-making capacity of clinicians in such
contexts.
Conclusions: In surgical oncology, time-sensitive environments require
more dierentiated views of XAI and human accountability. ey ignite
calls for increased metacognitive activities of clinicians involved.
Disclosure Statement: e authors declare no conict of interest.
913
Application of deep neural networks for the detection of
bladder cancer: a feasibility study using a domain transfer
Philipp Maisch1; Thomas Wittenberg2,3; Thomas Eixelberger2;
Sebastian Belle4; Stephan Kruck5; Maximilian Kriegmair6; Christian Bolenz1
1Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Ulm,
Deutschland
2Fraunhofer-Institut für Integrierte Schaltungen IIS, Erlangen, Deutschland
3Lehrstuhl für Graphische Datenverarbeitung, FAU Erlangen, Erlangen,
Deutschland
4Klinik für Gastroenterologie der Universitäts-Medizin Mannheim, Mannheim,
Deutschland
5Klinik für Urologie, Siloah St. Trudpert Klinikum, Pforzheim, Deutschland
6Urologische Klinik München-Planegg, München, Deutschland
Background: In order to increase the detection rate of bladder cancer
(BCa) during white-light cystoscopy and transurethral resection, meth-
ods such as photodynamic diagnosis or narrow band imaging have been
developed in recent years. e application of articial intelligence (AI)
using deep neural networks (NN) may improve the detection rate of BCa.
Methods: Initially, a NN with a YOLOv7-tiny architecture for real-time
object detection was iteratively trained on > 35,000 white-light colono-
scopic images with suspicious lesions. e classication rate of this NN
has a precision = 0.92, a sensitivity = 0.90 and a F1 value = 0.91. For our
multicenter study, 406 cystoscopic individual images (n = 117 patients)
with lesions and 251 negative ndings (normal urothelium), as well as
19 cystoscopic video sequences were prospectively recorded. All lesions
presented in the data were annotated and veried by urology specialists.
Result: All cystoscopic images were analyzed with the NN. An ad hoc detec-
tion of suspicious lesions in the urinary bladder was possible in the majority
of the ndings. Based on the cystoscopic image data, the NN provided a pre-
cision = 0.82, a sensitivity = 0.77 and F1 value = 0.79. Due to the YOLOv7-
tiny architecture, single images could be processed within 17 to 20 ms.
Discussion: is feasibility study indicates that the proposed domain
transfer approach (from colonoscopy to cystoscopy), with additional
images from cystoscopy, is viable to create a model for detecting BCa in
real time. Satisfactory detection rates for suspicious lesions were already
evident in the early phase of this study.
Conclusion: e methodology presented could accelerate the spread of
AI in the context of “enhanced cystoscopy”. It may be conceivable that the
presented domain transfer approach could also be used in other areas of
diagnostics, e.g., sonography.
Disclosure Statement: e authors declare no conict of interest.
Biomarker
352
6th Nationwide Tumor-biological Testing Survey in Patients
with NSCLC in Germany – Current Results and Development of
Testing Behavior since 2012
Sonja Loges1,2,3; Bärbel Söhlke4; Helmut Ostermann5
1DKFZ-Hector Cancer Institute, University Medical Center Mannheim,
Mannheim, Deutschland
2Division of Personalized Medical Oncology (A420), German Cancer Research
Center (DKFZ), Heidelberg, Deutschland
3Department of Personalized Oncology, University Hospital Mannheim,
Medical Faculty Mannheim, University of Heidelberg, Mannheim, Mannheim,
Deutschland
4zielGENau e. V., Köln, Deutschland
5LMU University Hospital, München, Deutschland
Background: Personalized drug therapy following assessment of molec-
ular alterations in tumor tissue has become standard-of-care in stage IV
NSCLC. Also neoadjuvant and adjuvant treatment options in early stage
NSCLC require biomarker testing. We determine whether testing in
Germany is performed as per guideline recommendations, which foresee
companion diagnostics guided drug therapy from which many patients
benet considerably.
Methods: ~100 Experienced oncologists from dierent types of health
care institutions (lung cancer centers, university/ non-university hospi-
tals, oce-based physicians) are asked to answer a questionnaire on the
details of testing. Data are analyzed by explorative analysis and compared
with previous data from 2012 to 2023.
Result: As previous surveys from this group have shown, biomarker
testing in early stage NSCLC is going to be established in Germany with
increasing testing rates until today. In late stage NSCLC established
marker like EGFR, PD-L1, ALK, ROS are on a plateau level, however test-
ing rates of other biomarkers are much behind with testing rates of ~60%
and below. e results of the new survey which is currently ongoing will
clarify whether important improvements in testing rates have occurred
over the past 2 years.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 25
Discussion: Overall there is still potential for improvement in Germany
in terms of the optimal use of therapy options. As most of the participated
institutions are now expected to be certied as lung cancer centers and/
or associated with network associations like nNGM we will investigate
whether this corresponds to an increase in guideline adherence.
Conclusion: In Germany many lung cancer patients still do not have
access to comprehensive molecular diagnostics and adequate personal-
ized therapy. In order to close the substantial gap between the potential
use of molecularly stratied therapies and the reality of care and to pro-
vide targeted therapy to as many eligible patients as possible, testing rates
of molecular markers in NSCLC must continue to increase.
Disclosure Statement: e authors declare the following: is study was
supported by AstraZeneca.
524
Impact of liquid biopsy preanalytics on cfDNA fragmentation
analyses
Ariane Hallermayr1,2,3; Thomas Keßler1,3; Courtney König1,3;
Selina Gisinger1; Verena Steinke-Lange1,2,3; Elke Holinski-Feder1,2,3;
Inés Aznar-Peralta4,5; M. Jose Serrano4,6; Carmen Carmen Garrido-Navas4,6
1MGZ – Medizinisch Genetisches Zentrum, Munich, Deutschland
2Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der
Universität München, Munich, Deutschland
3European Liquid Biopsy Society, Hamburg, Deutschland
4Centro Pzer - Universidad de Granada - Junta de Andalucía Centre for
Genomics and Oncological Research (GENYO), Granada, Spanien
5Biochemistry and Molecular Biology Doctoral Programe, Universidad de
Granada, Granada, Spanien
6IBS Granada, Institute of Biomedical Research. Avenida de Madrid 15, Granada,
Spanien
Background: Recent studies indicate the potential of the untargeted
detection of lowest levels of circulating tumor DNA (ctDNA) based on
fragmentation analysis of total circulating free DNA (cfDNA). Here, we
performed a pilot study to evaluate the impact of preanalytics on cfDNA
fragmentomics.
Methods: Blood samples from 10 healthy individuals and 3 patients with
metastatic colorectal cancer (CRC) were collected in citrate tubes at the
partner site in Granada. To investigate the impact of sample shipping and
cfDNA isolation on cfDNA fragmentation, cfDNA was isolated using
manual and automated extraction methods. e eects of dierent prea-
nalytical workows on sensitivity and specicity of fragmentation-based
ctDNA detection were evaluated using the whole-genome sequencing
(WGS)-based LIquid biopsy Fragmentation, Epigenetic signature, and
Copy Number Alteration analysis (LIFE-CNA), previously developed by
the partner site in Munich.
Result: Plasma cfDNA concentration in samples collected from healthy
individuals in citrate tubes was signicantly higher than in the panel of
normals with blood samples collected in Streck tubes (p-value < 0.05). e
dierent isolation methods did not result in signicantly dierent plasma
cfDNA concentrations. With LIFE-CNA, no major dierences regarding
the analyzed parameters, such as cfDNA fragmentation and chromatin
signatures, were observed to be dependent on the preanalytical.
Discussion: Within our pilot study we showed that neither dierences in
sample collection tubes nor dierences in cfDNA isolation workows had
a signicant impact on cfDNA fragmentation analysis. ese preliminary
results suggest that cfDNA samples shipped across Europe can be used for
fragmentation-based ctDNA detection.
Conclusion: In the framework of our collaboration we will initiate a larger
study to investigate the performance of targeted and fragmentation-based
ctDNA analysis for the early detection of CRC in a larger cohort of early
and late-stage patients.
Disclosure Statement: e authors declare no conict of interest.
545
Clinical relevance of pre-treatment testing to identify
DPD-decient patients at increased risk of severe toxicity
Panoraia Arni1; Michael Stahl1; Alexander Traut2
1Internistische Onkologie und Onkologische Palliativmedizin, Evang. Kliniken
Essen-Mitte, Essen, Deutschland
2Klinik für Gynäkologie und Gynäkologische Onkologie, Evang. Kliniken
Essen-Mitte, Essen, Deutschland
Background: e German Oncology Societies have endorsed the recom-
mendation of the European Medicines Agency (EMA) that all patients
(pts) should be tested for DPD deciency prior to systemic treatment with
uoropyrimidines (FP). Despite having treated approximately 150 pts per
year, about 1 pt per year had to be treated for severe toxicities that would
have indicated a relevant reduction in DPD activity. erefore, the organ-
isational and nancial burden of DPD testing in all pts prior to the FP use
should be questioned.
Methods: All pts with gastrointestinal carcinoma receiving rst-line FP
from June 2020 until May 2021 were included. ere were 2 groups, pts
with and without DPD testing. DPD testing was only performed if a delay
in therapy pending the test result was justied. Pts from both groups were
selected for statistical comparison using matched-pair analysis. e pri-
mary endpoint was the occurrence of serious toxicities leading to hospi-
talisation or treatment-related death. Secondary endpoints were toxicities
I-II° CTC and III-IV° CTC.
Result: Of the 164 pts studied, 119 were tested for DPD deciency and
45 were not. A DPD mutation (haplotype B3, heterozygous) was detected
in 6 of the pts (5.0%) in the tested group. Emergency hospitalisation was
required in 24 pts (20.2%) in the tested group versus 12 pts (26.7%) in the
non-tested group. Treatment-related death occurred in 4 pts (3.4%) in the
tested group versus 2 pts (4.2%) in the group without test (p>0.05). 53
pts (44.5%) in the tested group experienced toxicity I-II° CTC (stomatitis,
diarrhea, leucopenia, HFS) versus 16 pts (35.6%) in the non-tested group.
29 pts (24.4%) versus 19 pts (42.2%) experienced grade III-IV° CTC tox-
icity in the group with and without test, respectively.
Discussion: Clinical parameters (age, line of treatment, FP monotherapy
or in combination) relevant to treatment toxicity should also be evaluated.
Conclusion: In our retrospective analysis, there was no signicant dif-
ference between the two groups in prevention of serious toxicities and
consecutive need for hospital admission.
Disclosure Statement: e authors declare no conict of interest.
616
THSD7A is a potential biomarker in prostate cancer and in
squamous cell carcinoma of the lung
Fidelis Flockerzi; Phillip Stahl
Department of Pathology, Saarland University Medical Center, Homburg/Saar,
Deutschland
Background: In a former study we were able to show that rombospondin
Type-1 Domain containing 7A (THSD7A)-overexpression is associated
with unfavorable prognostic parameters in prostate cancer and with PSA
recurrence. Furthermore, several other studies indicate that THSD7A
might at least play a role in the prognosis of dierent tumor types.
ere is also evidence that Focal Adhesion Kinase (FAK) might be acti-
vated by THSD7A. We aimed to examine the role of THSD7A as a poten-
tial biomarker in prostate cancer and squamous cell carcinoma of the lung
(LSCC). In addition, we analyzed the impact of THSD7A-positivity on the
expression level of FAK in its unphosphorylated form.
Methods: Expression status of THSD7A and FAK were analyzed by
immunohistochemistry (IHC) using tissue microarrays (TMA) (n=461
prostate cancer samples, n=101 lung cancer samples).
Results: In prostate cancer, THSD7A-positivity was signicantly asso-
ciated with unfavorable prognostic parameters. In addition, THSD7A-
positivity was signicantly associated with high FAK-expression. In
LSCC, THSD7A-positivity was associated with poor overall survival in
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts26
the subgroup of female patients. THSD7A-positivity at least showed a
tendency towards high FAK-expression in this subgroup.
Discussion: To our knowledge, we are the rst to show that THSD7A-
positivity is signicantly associated with high FAK expression in pros-
tate cancer and at least shows a tendency towards high FAK-expression
in female patients with LSCC. Furthermore, THSD7A positivity predicts
poor overall survival in female patients with LSCC and is associated with
unfavorable prognostic parameters in prostate cancer.
Conclusion: Our results might be a proof of the assumed activation of
FAK-dependent signaling pathways by THSD7A. THSD7A is a membrane-
associated protein and therefore must be discussed as a putative therapeutic
target in prostate cancer and squamous cell carcinoma of the lung.
Disclosure Statement: e authors declare no conict of interest.
660
Prevalence of clinically relevant established and emerging
biomarkers in mNSCLC in a German study cohort
Stefanie Schatz; Markus Falk; Stefanie Schmidt; Markus Tiemann
Institut für Hämatopathologie, Hamburg, Deutschland
Background: New targeted and immune therapies are available or
expected to be approved in Europe for metastatic NSCLC including
HER2 directed ADCs, KRAS G12C specic targeted therapies or double
IO/chemo combinations. We evaluated real-world frequency of predic-
tive/prognostic alterations in light of these therapies, including the genes
EGFR, HER2, KRAS and STK11 as well as KRAS/STK11 co-mutations.
Methods: We retrospectively analyzed 700 NSCLC samples from our
internal documentation system of 2022. All specimens were sequenced
by hybrid capture NGS, based on the Agilent XTHS2 chemistry and the
Illumina NextSeq 500 sequencing platform. Histological and mutation
subtypes were evaluated.
Result: Adenocarcinomas (N=546) carried 40.8% (N=223) KRAS muta-
tions (N=95 KRAS G12C). Inactivating STK11 mutations were present
in 16.1% of cases (8.3% KRAS co-mutated) followed by activating EGFR
(12,8%) and activating HER2 mutations (0.7%) plus 1.1% HER2 ampli-
cations (CNV). In non-adenocarcinomas (N=154) we found 1,9% (N=3)
activating EGFR and 8.4% (N=13) KRAS mutations, however no KRAS
G12C.
Discussion: We analyzed the frequency of relevant alterations that may
serve as predictive/prognostic biomarkers to current and upcoming ther-
apies in a real-world setting. While KRAS and STK11 mutated subgroups
have been associated with a worse outcome, data from clinical trials like
POSEIDON indicate that KRAS and STK11 mutated subgroups may ben-
et from double IO/chemo combinations. KRAS constituted the most
common driver alteration and was highly co-mutated with STK11. HER2
as a potential target rarely carried activating mutations.
Conclusion: With new indications on the horizon for metastatic NSCLC,
it is important to understand frequency of molecular drivers and the
impact of co-mutations on targeted and IO treatment. In the molecular
pathological report it is critical to clearly decipher pathogenic variants
from those with unknown clinical signicance.
Disclosure Statement: e authors declare the following: is study was
supported by AstraZeneca.
775
Assessing the immunological consequence of metastatic
potential- linking MACC1 and immune evasion
Sebastian Torke; Reyhan Rose Divarci; Wolfgang Walther; Ulrike Stein
Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin
and Max-Delbrück Centrum, Berlin, Deutschland
Background: Metastasis formation is the most lethal attribute of cancer,
critically limiting survival and therapeutic options. To improve patient
outcomes, knowledge on targetable markers, representing causal driv-
ers of metastasis, is essential. Our laboratory has identied metastasis
associated in colon cancer 1 (MACC1), a driver of metastasis in more
than 20 cancer entities. One prerequisite for metastasis is the evasion of
immune response. While MACC1 is central in many processes of cancer
progression, how it regulates immune evasion is poorly understood.
Methods: Using cells with low (SW480), moderate (HCT116) and high
(SW620) endogenous MACC1 expression, and transgenic variants with
MACC1 overexpression or knockout, we analyzed the expression of
immunologically relevant markers. Furthermore, we assessed how tumor
intrinsic MACC1 expression aects the activation of T cells and T cell-me-
diated tumor cell killing using live cell imaging.
Result: MACC1 induces CD95 (Fas), a death receptor that possesses
various tumor-promoting functions. e immune checkpoints (IC)
PD-1 and PD-L1 were increasingly expressed in cells with high MACC1.
Stimulating T cells with conditioned medium from MACC1-high tumor
cells decreased the expression of CD95 and CD69, highlighting a reduced
activation. In a co-culture we observed that MACC1 expression protected
tumor cells from T cell-mediated killing.
Discussion: Taken together, we report that MACC1 mediates mechanisms
of immune escape. Currently, we are using cyclic immunouorescence on
patient-derived tissues to analyze the distribution of immunologically rel-
evant markers in dependence to MACC1. Especially the spatial resolution
of tumor–immune cell interactions as well as IC expression in regard to
MACC1 will provide novel insight into immune evasion strategies utilized
by tumor cells.
Conclusion: Overall, we aim to establish the relevance of MACC1 in
the interaction of tumor and immune cells. is knowledge enables us
to assess immunotherapies in a clinical context relevant to the individual
metastatic risk.
Disclosure Statement: e authors declare no conict of interest.
779
SARIFA, a new prognostic histomorphological biomarker in
gastric cancer identies cases with a distinct biology – a post
hoc analysis of the ST03 trial
Bianca Grosser1; Stefan Schiele1; Nic Reitsam1; Jake Emmerson2;
David Cunningham3; Matt Nankivell4; Ruth Langley4; William Allum5;
Martin Trepel6; Bruno Märkl7; Heike Grabsch8
1Pathology, Medical Faculty Augsburg, University of Augsburg, Augsburg,
Deutschland
2Leeds Institute of Clinical Trials Research, University of Leeds, Leeds,
Deutschland
3Department of Medicine, Royal Marsden Hospital, Sutton, Surrey, United
Kingdom
4Medical Research Council Clinical Trials Unit at University College London,
London, United Kingdom
5Department of Oncology and Department of Surgery, Royal Marsden NHS
Foundation Trust, London, United Kingdom
6Department of Internal Medicine II, Hematology and Oncology, Medical
Faculty Augsburg, University of Augsburg, Augsburg, Deutschland
7Pathology, Medical Faculty Augsburg, University of Augsburg, Augsurg,
Deutschland
8Department of Pathology, GROW School for Oncology and Reproduction,
Maastricht University Medical Center+, Maastricht, Niederlande
Background: Recently, we dened SARIFA as a new histomorphological
biomarker in GI cancers by the occurrence of stroma areactive invasion
front areas with at least ve tumor cells with direct contact with adipo-
cytes. Data from basic research indicate a switch toward lipid metabolism
caused by this interaction.
Methods: We analyzed digitalized H&E-stained slides of 640 patients. In
contrast to the original denition, where we assumed SARIFA positivity
beginning from a singular area with ve cells, we investigated a poten-
tial quantitative eect. Based on the percentage of histological slides with
SARIFA-positive areas, SARIFA has been stratied into four (negative,
low, intermediate, high) or three categories (negative, low, high), respec-
tively. Log-rank tests and Cox proportional hazard models have been cal-
culated for overall survival.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 27
Result: SARIFA-positivity was found in 322 (50%), cases and proved to be
a strong negative prognostic biomarker. Moreover, a quantity-dependent
eect could be determined with HRs of HRs of 1.00, 2.48, 2.74 and 3.72
for the 4-tiered system and 1.00, 1.86, 2.79 for the 3-tiered system, respec-
tively. Even, the SARIFA-low group was associated with an adverse out-
come. Moreover, this prognostic eect was signicant independently from
other established risk factors (pT, pN, R-status, Chemotherapy).
Discussion: We could demonstrate a quantity-dependent eect of
SARIFA in gastric cancer. Importantly, the survival dierence between
SARIFA-negative and -low cases is much stronger compared to the dif-
ference between the two or three SARIFA-positive groups, respectively.
is indicates a strong biological mechanism behind this morphological
phenomenon that holds true even in cases with low frequency. Based
on previous data, we suggest a distinct tumor biology driven by lipid
metabolism.
Conclusion: SARIFA is a strong prognostic marker with a quantitative
eect. However, even a low frequency is linked with such a strong power
that a two-tiered system is recommended.
Disclosure Statement: e authors declare no conict of interest.
793
Immunocytochemistry Proling of Circulating Tumor Cells for
Accurate Determination of mTOR and ARv7 Expression Status
Stefan Schuster1; Felix Melchior1; Dadasaheb Akolkar2; Darshana Patil2
1Datar Cancer Genetics Europe GmbH, Bayreuth, Deutschland
2Datar Cancer Genetics Limited, Nashik, Indien
Background: Clinical decisions including selection of anticancer agents
are oen based on biomarker status on tissue samples. Tumor tissue insuf-
ciency and heterogeneity along with tumor evolution as well as acquired
resistance necessitate the need to look for liquid biopsy-based evaluation.
We present the performance of a circulating tumor cells (CTCs) based test
to determine the expression of mammalian target of Rapamycin (mTOR)
in various cancers and androgen receptor v7 (ARv7) in prostate cancer.
Methods: Tumor tissue samples and matched pre-biopsy blood samples
were obtained from 62 patients with breast (n = 29), lung (n = 19) or
prostate (n = 14) cancers. Tumor derived cells and CTCs were collected
from tumor tissue and blood samples respectively1 and proled by immu-
nocytochemistry to determine status of mTOR in breast and lung cancers
and ARv7 in prostate cancer.
Result: Concordance rates of mTOR in breast cancer were 66.67% (posi-
tive, n = 3), 100% (negative, n = 26), and 96.6% (overall, n = 29). In lung,
concordance rates were 100% for both, positive (n = 11) and negative
(n=8), cases with an overall rate of 100% (n = 19). e combined results
for mTOR in breast and lung were 92.9% (positive, n = 14), 100% (neg-
ative, n = 34), and 97.9% (overall, n = 48). For prostate (n = 14), CTC
analysis of ARv7 demonstrated 100% sensitivity (positive, n = 4) and 80%
specicity (negative, n = 10). CTCs were notably eective in detecting
acquired resistance related to ARv7.
Discussion: e allure of blood-based methods lies in their inherent
accessibility. Amidst CTC-driven techniques, achieving comparability has
posed a substantial hurdle as some methods have failed do demonstrate
clinical relevance. Yet, our approach reconrms CTCs’ signicant treat-
ment contribution. e congruence between mTOR and ARv7 expression
on CTCs and tumor tissue underscores their reliable potential.
Conclusion: Our study strengthens the value of CTC based biomarker
testing in clinical settings as a viable alternative to tissue-based testing.
Reference:
1 Crook T et al. DOI: 10.1007/s00280-020-04189-8.
Disclosure Statement: e authors declare the following: S.S. and F.M. are
employed at Datar Cancer Genetics Europe GmbH, Bayreuth, Germany, and P.V.
and D.P. are employed at Datar Cancer Genetics Ltd., Nasik, India, both together
focusing on new diagnostic solutions in oncology.
858
Liquid biopsy in colorectal cancer - Beyond the targeted
analysis of single variants
Ariane Hallermayr1,2,3; Tobias Wohlfrom1; Verena Steinke-Lange1,2,3;
Anna Benet-Pagès1,4; Florentine Scharf1; Ellen Heitzer3,5,6,7;
Ulrich Mansmann8; Christopher Haberl9; Maike de Wit10,11;
Holger Vogelsang12; Markus Rentsch13,14; Elke Holinski-Feder1,2,3;
Julia MA Pickl1,2
1MGZ – Medizinisch Genetisches Zentrum, Munich, Deutschland
2Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der
Universität München, Munich, Deutschland
3European Liquid Biopsy Society, Hamburg, Deutschland
4Institute of Neurogenomics, Helmholtz Zentrum München - German Research
Center for Environmental Health, Neuherberg, Deutschland
5Institute of Human Genetics, Diagnostic and Research Center for Molecular
Biomedicine (Austria), Medical University of Graz, Graz, Österreich
6BioTechMed-Graz, Graz, Österreich
7Christian Doppler Laboratory for Liquid Biopsies for Early Detection of Cancer,
Graz, Österreich
8Institute for Medical Information Processing, Biometry, and Epidemiology–IBE,
LMU Munich, Munich, Deutschland
9Department of Oncology and Hematology, Barmherzige Brüder, Klinikum St.
Elisabeth, Straubing, Deutschland
10Department of Hematology, Oncology and Palliative Medicine, Vivantes
Klinikum Neukoelln, Berlin, Deutschland
11Department of Oncology, Vivantes Auguste-Viktoria-Klinikum, Berlin,
Deutschland
12Department of General, Visceral, Thoracic and Endocrine Surgery, Klinikum
Garmisch-Partenkirchen, Teaching Hospital, Ludwig Maximilian University
Munich, Garmisch-Partenkirchen, Deutschland
13Department of General, Visceral and Thorax Surgery, Klinikum Ingolstadt,
Ingolstadt, Deutschland
14Department of General, Visceral, Vascular and Transplant Surgery, University
Hospital Munich, Ludwig-Maximilians University of Munich, Campus
Großhadern, München, Deutschland
Background: e main focus in liquid biopsy diagnostics is on circulat-
ing tumor DNA (ctDNA) analysis, targeting actionable hotspot variants
to guide treatment decisions. We developed a whole-genome sequencing
(WGS)-based approach for untargeted ctDNA analysis providing a prom-
ising tool for real-time monitoring of cancer patients.
Methods: We established LIquid biopsy Fragmentation, Epigenetic signa-
ture and Copy Number Alteration analysis (LIFE-CNA) using WGS with
~6x coverage in 259 plasma samples collected from healthy individuals
and colorectal cancer (CRC) patients.
Result: Using 55 healthy controls, we established distinct cutos for the
detection of ctDNA based on global and regional fragmentation patterns,
transcriptionally active chromatin and somatic copy number alterations.
is enabled the accurate prediction of ctDNA in 81% of patients with
localized and in 94% of patients with metastatic disease at the time of pri-
mary diagnosis. By adding a machine learning classier to our workow,
which combines global and regional cfDNA fragmentation, we were able
to increase the accurate prediction of ctDNA presence (93% of patients
with localized and 94% of patients with metastatic disease at diagnosis).
By following individual patients throughout their course of disease, we
observed that changes in ctDNA signals reliably predicted response or
progression up to 5 months prior to clinical manifestation in 77% or 100%
of patients, respectively.
Discussion: We developed and validated a sensitive and cost-eective
method for untargeted ctDNA detection at the time of diagnosis or recur-
rence, as well as for treatment monitoring, expanding the advantages of
liquid biopsy.
Conclusion: Our approach is applicable to a wide range of cancer patients,
and with minor adjustments in the bioinformatics analysis, LIFE-CNA
could be easily extended to all tumor entities. e high sensitivity and
cost-eectiveness of our approach form the basis for the implementation
of LIFE-CNA into clinical practice.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts28
Breast Cancer
49
Tucatinib in patients with locally advanced or metastatic
HER2-positive breast cancer who received at least two prior
anti-HER2 treatment regimens: Study design of the
non-interventional study TRACE in Germany and Austria
Arnd Nusch1; Moritz Angerer2; Manfred Welslau3; Christoph Uleer4;
Julia Radosa5; Denise Wrobel6; Stefanie Noeding7; Klaus Apel8;
Jürgen Terhaag9; Ingo Tamm10; Lelia Bauer11; Marija Balic12; Daniel Egle13;
Nadia Harbeck14; Volkmar Müller15; Eva Schumacher-Wulf16;
Rebecca de Buhr17; Martin Glasstetter17; Johanna Hanselmann17;
Cathrin Hogrefe17; Norbert Marschner17; Katja Gratze17; Rupert Bartsch18;
Anja Welt19
1Praxis für Hämatologie und Onkologie, Ratingen, Deutschland
2Schwerpunktpraxis Hämatologie & Internistische Onkologie, Fürth,
Deutschland
3MVZ am Klinikum Aschaenburg GmbH, Aschaenburg, Deutschland
4Praxisgemeinschaft Gynäkologische Onkologie & spezielle oparative
Gynäkologie, Hildesheim, Deutschland
5Universitätsklinikum des Saarlandes, Homburg (Saar), Deutschland
6Sozialstiftung Bamberg Klinik für Frauenheilkunde und Geburtshilfe, Bamberg,
Deutschland
7Dr. Stefanie Noeding, Gynäkologie & medikamentöse Tumortherapie, Siloah
Krankenhaus // Haus K, Hannover, Deutschland
8Dr. Apel Medizinische Versorgung GmbH, Erfurt, Deutschland
9Frauenärzte am Schellenbruckplatz MVZ Eggenfelden GbR, Eggenfelden,
Deutschland
10Onkologische Schwerpunktpraxis Kurfürstendamm, Berlin, Deutschland
11GRN-Klinik Weinheim, Weinheim, Deutschland
12LKH-Univ. Klinikum Graz, Graz, Österreich
13Medizinische Universität Innsbruck, Innsbruck, Österreich
14Klinikum der Universität München, München, Deutschland
15Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
16Mamma Mia – Die Krebsmagazine, atp Verlag GmbH, Köln, Deutschland
17iOMEDICO AG, Freiburg im Breisgau, Deutschland
18Medizinische Universität Wien, Wien, Österreich
19Universitätsklinikum Essen, Essen, Deutschland
Background: Tucatinib (TUC), a highly selective HER2 tyrosine kinase
inhibitor, combined (comb.) with trastuzumab (TRAS) + capecitabine
(CAPE), demonstrated a signicant overall and progression-free survival
benet compared to placebo + TRAS + CAPE1, 2 in the HER2CLIMB
trial and has been approved in Europe for HER2+ advanced breast can-
cer (ABC) patients (pts) aer ≥ 2 prior anti-HER2 therapies. TRACE will
collect real-world (rw) data of TUC + TRAS + CAPE according (acc.)
to SmPC, including pts underrepresented or excluded from the pivotal
trial like elderly pts or pts treated with TUC in early ABC treatment lines.
Moreover, data on TUC combination therapy (TH) aer prior TH with
TRAS-Deruxtecan will be gathered.
Methods: is non-interventional trial will document up to 300 HER2+
ABC pts scheduled to receive TUC + TRAS + CAPE acc. to SmPC in 60
German & 10 Austrian sites. 150 pts each (up to 30 Austrian pts each)
will be enrolled into the 1st/2nd & 3rd/4th line cohorts. Primary endpoint
is time to deterioration of patient-reported global quality of life (QoL)
in EQ-5D-5L, EORTC QLQ-C30, and QLQ-BR23 questionnaires.
Descriptive statistics will be used to analyze changes in the functional and
symptom sub-scores compared to baseline, as well as eectiveness (e.),
safety, physician decision making, details on TUC treatment, TH manage-
ment, and treatment sequences.
Result: n.a.
Discussion: n.a.
Conclusion: TRACE will provide important rw insights into treatment
with TUC + TRAS + CAPE for HER2+ ABC pts with focus on QoL, e.
and safety. Preplanned subgroup analyses will ll important knowledge
gaps between the pivotal trial and routine clinical practice.
Indication of source:
1 Murthy RK et al: Tucatinib, trastuzumab, and capecitabine for HER2-positive
metastatic breast cancer. N Engl J Med 382(7): 597–609, 2020.
2 Curigliano G et al: Tucatinib versus placebo added to trastuzumab and
capecitabine for patients with pretreated HER2+ metastatic breast cancer with
and without brain metastases (HER2CLIMB): nal overall survival analysis.
Ann Oncol 33(3): 321–329, 2022.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
51
A Randomized Controlled Trial of Argentine Tango to Improve
Cancer-Related Fatigue and Quality of Life in Breast Cancer
Survivors
Jessica Groß1, Shiao LI Oei2, Anja Thronicke2, Thomas Rieser2,3,
Sarah Becker1, Patricia Grabowski4,5, Gerrit Grieb6, Harald Matthes2,3,
Friedemann Schad2,4
1Brustzentrum, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Deutschland
2Forschungsinstitut Havelhöhe, am Gemeinschaftskrankenhaus, Berlin,
Deutschland
3Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité –
Universitätsmedizin Berlin, Berlin, Deutschland
4Onkologisches Zentrum, Interdisziplinäre Onkologie und Palliativmedizin
Gemeinschaftskrankenhaus Havelhöhe, Berlin, Deutschland
5Institut für Medizinische Immunologie, Charité – Universitätsmedizin Berlin,
Berlin, Deutschland
6Plastische Chirurgie und Handchirurgie, Gemeinschaftskrankenhaus
Havelhöhe, Berlin, Deutschland
Background: Persistent impairments of health-related quality of life
(QoL), in particular cancer-associated fatigue, are major limitations for
cancer survivors. As physical activity and mindfulness interventions have
been shown to be eective, we investigated the ecacy of a six-week
Argentine Tango program on QoL outcomes of breast cancer survivors.
Methods: A randomized controlled trial was conducted with 60 breast
cancer survivors diagnosed with stage I-III tumors 12-48 months prior to
study enrollment and who had increased symptoms of fatigue. e partic-
ipants were randomly assigned with a 1:1 allocation to either the Tango or
the Waiting group. e Tango program consisted of six weekly one-hour
group sessions. Using the EORTC QLQ C30 and the German version of
the Cancer Fatigue Scale QoL parameters were assessed and additionally
pre-post analysis of QoL changes, also 6 and 12 months thereaer were
performed and compared with a historical control cohort of 108 breast
cancer survivors.
Result: A total of 52 participants completed the Tango and Waiting assess-
ments. Superiority of the Tango intervention over the Waiting list control
was found in terms of improvement in fatigue (d = -0.64; 95%CI, -1.2 to
-0.08; p = 0.03), especially cognitive fatigue. A pooled pre-post analysis
of the 50 participants completing the six-week Tango program revealed a
close to 10% improvement of fatigue (p = 0.0003), insomnia (p = 0.008)
and further QoL outcomes. Aer six months, signicant improvements in
fatigue (p=0.006), physical functioning (p=0.01), and diarrhea (p=0.04)
were still detectable in the Tango participants, but not in the control
cohort.
Discussion: is randomized controlled trial is the rst ecacy study
demonstrating that a Tango program improved fatigue and QoL in breast
cancer survivors and that this improvement persisted for at least six
months.
Conclusion: Meanwhile, exercise, moderate resistance training, and
physical activity are part of international oncology guidelines, and these
may be expanded to include dance.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 29
61
A real-world prospective observational multi-national study
in adult patients with breast cancer treated with extended
adjuvant neratinib: NERLYFE study
Dirk-Toralf Baerens1; Nadia Harbeck2; Apurna Jegannathen3;
Baschar Youssef4; Hossam Abdulkhalek5; Mark Davies6; Martin Smakal7;
Martina Zimovjanova8; Marcus Schmidt9; Farida Beghdad10;
Marta Zivanov10; Rupert Bartsch11
1Gemeinschaftspraxis für Gynäkologie, Ilsede/Groß Ilsede, Deutschland
2Comprehensive Cancer Center of the Ludwig-Maximilians-University, Breast
Center, Department of Gynecology and Obstetrics, Munich, Deutschland
3University Hospitals of North Midlands NHS Trust Stoke-on-Trent, Department
of Oncology, Staord, United Kingdom
4Städtische Kliniken Mönchengladbach, Brustzentrum, Mönchengladbach,
Deutschland
5Western Health and Social Care Trust, Altnagelvin Hospital, North West Cancer
Centre, Londonderry, United Kingdom
6Singleton Hospital, Swansea, Sketty, Swansea, United Kingdom
7Onkologicke Oddelení, Nemocnice Horovice, Horovice, Tschechische Republik
8Charles University, General Hospital Prague, Department of Oncology, Prague,
Tschechische Republik
9University Medical Center Mainz, Mainz, Deutschland
10Pierre Fabre, Boulogne Billancourt, Frankreich
11Medical University of Vienna, Clinical Research Unit Division of Oncology
Department of Medicine I, Wien, Österreich
Background: Neratinib is an oral pan-HER TKI approved in Europe
in adult patients with early-stage HR+ HER2+ breast cancer who com-
pleted adjuvant trastuzumab-based therapy ≤ 1 year ago. In the phase III
ExteNET study, neratinib demonstrated an iDFS advantage of 5.1% at 5
years in the HR+/HER2+ population. Without mandated antidiarrheal
prophylaxis the most common AE reported was diarrhoea (39% grade 3).
Methods: NERLYFE is a post-authorization safety study (PASS), investi-
gating real-world incidence and management of diarrhoea with neratinib.
368 patients will be enrolled in Austria, Czech Republic, Germany, and
the United Kingdom. Eligible patients will be assigned to receive extended
adjuvant neratinib as indicated in the SmPC and having received educa-
tional materials.
e primary objective is to characterize the incidence of permanent
discontinuation due to diarrhoea ≤3 months of neratinib treatment.
Secondary objectives will characterize diarrhoea patterns, treatment
maintenance, the impact of treatment-related diarrhoea on QoL, and
the eectiveness of the educational materials by patients and physicians.
To gather information on cancer recurrence, an ancillary protocol will
describe clinical outcomes at 2 years (iDFS, DDFS, CNS events, OS). e
follow-up of patients is planned from treatment initiation until 24 months.
Result: As of 24/07/2023, 44 sites in four European countries enrolled 51
patients. Final study results are expected in 2026.
Discussion: n.a.
Conclusion: In a real-world setting in Europe, this study will further
characterize neratinib-related diarrhoea in patients with early breast can-
cer treated with extended adjuvant neratinib. It will also assess the eec-
tiveness of the educational materials. e ancillary study will describe
clinical outcomes at 2 years.
Funding: e study is funded by Pierre Fabre. First published: St. Gallen 2023
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
96
HER2-Low expression in primary male breast cancer
Christian Rudlowski1; Melanie Erices-Leclercq1; Katleen Nobbe1;
Stephan Baldus2; Robert Förster3; Frank Förster4; Sabine Lubig1
1EVK, Bergisch Gladbach, Deutschland
2Institut für Pathologie und Zytopathologie, Bergisch Gladbach, Deutschland
3Institute for Radiation Oncology, Cantonal Hospital Winterthur, Winterthur,
Schweiz
4MVZ für Gynäkologische Onkologie und Palliativmedizin, Poliklinik GmbH,
Chemnitz, Deutschland
Background: Female breast cancer (FBC) expressing low levels of HER2
oers new treatment options with antibody-drug-conjugates. No evidence
was found that HER2-Low describes a new FBC subtype with specic
tumorbiological features and impact on survival. Studies are lacking to
determine the impact of HER2-Low in male breast cancer (MBC). Here,
we evaluate the prevalence of HER2-Low in primary MBC and correlate
the results with clinicopathologic features and outcome.
Methods: In this retrospective study histological specimens were obtained
from 120 male patients who were diagnosed and treated for primary inva-
sive breast cancer from 1995 to 2022 at Breast Cancer Units in Bergisch
Gladbach, Chemnitz and Zwickau, Germany. HER2 staining was per-
formed by central pathology and evaluated in accordance with the 2023
ASCO guidelines. HER2-Low expression was statistically correlated with
tumorbiological characteristics and patients outcome.
Results: 77 (64.2%) of cases were HER2 negative (HER2 0), 7 (5.8%) were
HER2 2+ (ISH negative), 32 (26.7%) were HER2-Low (1+). Four patients
(3.3%) showed HER2 positivity (3+). One patient was triple negative. Out
of the 77 HER2 negative cases 47 tumors (61.0%) show an incomplete
staining with < 10% of tumor cells classied as HER2 ultralow. No statis-
tical correlation between HER2-Low and tumorbiological characteristics
and patients survival was demonstrable.
Conclusion: Our ndings demonstrate a remarkable but lower prevalence
of HER2-Low expression in primary MBC compared to FBC. However,
HER2-Low expressing tumors show no specic tumorbiological fea-
tures to dene a new breast cancer subtype in MBC. Further studies are
required to better understand HER2-Low breast cancer in general and in
particular in MBC.
Disclosure Statement: e authors declare no conict of interest.
135
Evaluation of the age limits in the German mammography
screening program
Theresa Hunger; Elke Nekolla; Eva Wanka-Pail; Katharina Stella Winter;
Gunnar Brix
Bundesamt für Strahlenschutz, Oberschleißheim, Deutschland
Background: e German mammography screening program (MSP)
invites asymptomatic women aged 50–69 years to biennial breast cancer
screening. Increased life expectancy and European guidelines gave reason
to reassess the age limits. e Federal Oce for Radiation Protection has
the legal mandate to evaluate radiological screening examinations and
make recommendations to the Federal Ministry for Nature, Environmental
Protection, Nuclear Safety and Consumer Protection on their admissibility.
Methods: Benets and harms of mammography screening in women
under 50 and over 70 years of age were assessed in a systematic literature
review. e radiation risk was estimated on the basis of established radia-
tion epidemiological models, which were adapted to the German popula-
tion. Current exposure data were applied.
Result: ere is evidence from eight randomized controlled trials (RCT)
that mammography screening in women under the age of 50 can reduce
breast cancer mortality by about 18% (risk ratio (RR)=0.82; 95%-con-
dence interval (CI): 0.71–0.96). For women aged 70–74 years, evidence
from RCT is limited but also indicates a reduction of breast cancer mortal-
ity (RR=0.72; 95%-CI: 0.54-0.95). Radiation exposure in mammography
screening is low and the associated risk for women screened beyond the age
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts30
of 70 years is only marginally higher compared to current screening practice.
However, screening at ages 40–69 or ages 45–69 has an about 2-fold or
50% higher radiation associated excess lifetime risk, respectively, com-
pared to screening at ages 50–69.
Discussion: While more women could benet from the German MSP
when extending the age limits, older women have a higher risk of overdi-
agnosis due to competing death risks and lower remaining life expectancy,
and younger women face a higher radiation risk from screening.
Conclusion: From a radiation protection perspective and under the
aspect of preventing opportunistic screening, extending the age limits to
45–75years in the German MSP with the given high-quality standards is
justied.
Disclosure Statement: e authors declare no conict of interest.
175
Final analysis of the placebo-controlled randomised phase
3 IMpassion031 trial evaluating neoadjuvant atezolizumab
(atezo) plus chemotherapy (CT) followed by open-label
adjuvant atezo in patients (pts) with early-stage triple-
negative breast cancer (eTNBC)
Nadia Harbeck1; Carlos Barrios2; Amy Zhang3; Shigehira Saji4; Kyung Hae
Jung5; Roberto Hegg6; Andreas Köhler7; Joo Hyuk Sohn8; Hiroji Iwata9;
Melinda Telli10; J.-F. Boileau11; Kevin Punie12; Max Dieterich13; Zoe Assaf14;
Trista Xu15; Mario Liste Hermoso13; Esther Shearer-Kang16; Luciana
Molinero14; Stephen Chui17; Elizabeth Mittendorf18
1Breast Center, Department of Gynecology and Obstetrics and Comprehensive
Cancer Center, Ludwig-Maximilians-University Hospital, München, Deutschland
2Latin American Cooperative Oncology Group (LACOG), Oncoclínicas, Porto
Alegre, Brasilien
3Department of Pathology, Memorial Sloan Kettering Cancer Center, New York,
NY, USA
4Medical Oncology, Fukushima Medical University, Fukushima, Japan
5Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republik
Korea
6Gynecological Clinical Service School of Medicine, University of São Paulo,
São Paulo, Brasilien
7Haematologie und Onkologie, Gemeinschaftspraxis für Haematologie und
Onkologie Langen, Langen, Deutschland
8Yonsei Cancer Center, Yonsei University Health System, Seoul, Republik Korea
9Breast Oncology Dept., Aichi Cancer Center Hospital, Nagoya, Japan
10School of Medicine, Stanford University, Stanford. CA, USA
11Jewish General Hospital, McGill University, Montréal, QC, Canada
12Department of General Medical Oncology and Multidisciplinary Breast Centre,
Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgien
13Product Development Oncology, F. Homann-La Roche Ltd, Basel, Schweiz
14Oncology Biomarker Development, Genentech, South San Francisco, CA, USA
15Data and Statistical Sciences – Oncology, Homann-La Roche Limited,
Mississauga, ON, Canada
16Product Development Safety, Genentech, South San Francisco, CA, USA
17Product Development Oncology, Genentech, South San Francisco, CA, USA
18Department of Surgery, Dana-Farber Brigham Cancer Center, Boston, MA, USA
Background: IMpassion031 (NCT03197935) met its primary objective,
signicantly improving pathological complete response (pCR) rate with
atezo added to neoadjuvant CT in pts with eTNBC (58% vs 41% with
CT alone in the intent-to-treat [ITT] population; 17% dierence, 1-sided
p=0.0044) [Mittendorf 2020]. Benet from atezo was seen regardless of
PD-L1 status. We here present the nal analysis of IMpassion031.
Methods: Pts with untreated stage II/III eTNBC and a primary tumour
>2 cm were randomised 1:1 to placebo or atezo 840 mg q2w + neoadju-
vant CT (nab-paclitaxel 125 mg/m2 qw for 12 wk, then doxorubicin 60
mg/m2 + cyclophosphamide 600 mg/m2 q2w for 8 wk). Aer surgery, pts
randomised to atezo received open-label atezo 1200 mg q3w for 11 cycles.
Pts without pCR could have standard adjuvant systemic therapy (± atezo).
Stratication factors were disease stage (II vs III) and PD-L1 status (IC
<1% vs ≥1% by SP142). Secondary ecacy endpoints included event-free
survival (EFS), disease-free survival (DFS) and overall survival (OS) in the
ITT and PD-L1+ populations.
Results: Aer ~39 mos’ median follow-up, EFS, DFS and OS numerically
favoured atezo vs placebo consistently across key clinical subgroups (HR
(95% CI) for ITT population: EFS, 0.76 (0.47-1.21); DFS, 0.76 (0.44-1.30);
OS, 0.56 (0.30-1.04). Among pts without pCR, 14/70 (20%) in the atezo
arm vs 33/99 (33%) in the placebo arm received additional adjuvant sys-
temic therapy, most oen capecitabine (4/70 [6%] vs 26/99 [26%]). In
exploratory analyses, pCR was highly prognostic for long-term outcome.
Exploratory ctDNA analyses showed clearance in most pts at surgery.
Positive ctDNA at/aer surgery was associated with poor prognosis. ere
were no new safety signals or treatment-related deaths with atezo.
Conclusion: e signicant pCR benet with the addition of atezo to CT
for eTNBC translated into numerically improved EFS, DFS and OS. Long-
term safety results are consistent with previous reports.
Previously presented at ESMO-BC, LBA1, Carlos Barrios et al. - Reused with
permission.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
182
ELECTRA: An open-label, multicenter, phase 1b/2 study of
elacestrant in combination with abemaciclib in patients with
brain metastasis from estrogen receptor-positive (ER+),
HER2-negative (HER2-) breast cancer (BC)
Erika Hamilton1; Sung-Bae Kim2; Ahmad Awada3; Nancy Lin4; Sebastian
Züe5; Simona Scartoni6; Bartomeu Piza Vallespir7; Kathy Puyana Theall7;
Nuhad Ibrahim8
1Sarah Cannon Research Institute/Tennessee Oncology, Nashville, USA
2Asan Medical Center, Seoul, Republik Korea
3Jules Bordet Cancer Institute, Brussels, Belgien
4Dana-Farber Cancer Institute, Boston, USA
5Klinikum Worms, Worms, Deutschland
6Menarini Group, Florence, Italien
7Stemline Therapeutics/Menarini Group, New York, USA
8MD Anderson Cancer Center, Houston, USA
Background: Currently, there are no approved systemic treatment
options for patients (pts) with ER+/HER2- BC and brain metastasis.
e prevalence of brain metastases from ER+/HER2- BC is ~14% of
women (Aversa, 2014). Elacestrant is a next-generation oral SERD that
was evaluated in the pivotal phase 3 EMERALD trial, where elacestrant
demonstrated signicantly prolonged PFS vs SOC endocrine therapy in
pts with ER+/HER2− ESR1 mutated mBC following progression on prior
endocrine therapy (Bidard, 2022). Elacestrant was well tolerated with a
manageable safety prole. Most adverse events, including nausea, were
low-grade and consistent with other endocrine therapies. A clinical study
in healthy postmenopausal women demonstrated the ability of elacestrant
to cross the blood-brain barrier (Conlan, 2020). Abemaciclib, a CDK4/6i,
has been shown to achieve therapeutic concentrations in brain metasta-
ses tissue (Tolaney, 2020). Given the lack of current systemic treatments,
elacestrant is now being evaluated with abemaciclib in patients with ER+/
HER2- BC and brain metastasis.
Methods: ELECTRA (NCT05386108) is an open-label phase 1b/2, mul-
ticenter study evaluating elacestrant in combination with abemaciclib,
eligibility are in patients with ER+/HER2− locally advanced or mBC and
measurable brain metastasis. For phase 1b, the presence of brain metasta-
ses are allowed but not required for eligibility. For phase 2, patients must
have ≥ 1 active and measurable brain metastais per RECIST v1.1. Patients
must have received prior therapy in the metastatic setting, including ≥ 1
endocrine therapy, ≤ 2 chemotherapy regimens, and 0-2 prior CDK4/6i
(excluding abemaciclib). e Phase 1b primary objective is to determine
the recommended phase 2 dose; secondary objectives include safety, PK,
ORR, DoR, CBR, PFS, and OS. e phase 2 primary objective is ORR per
RECIST version 1.1; secondary objectives include intracranial response
rate, DoR, CBR, PFS, OS, PK, and quality of life. Recruitment is actively
ongoing.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 31
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
191
Retrospective single case reports on the treatment of
patients with HER2-positive/HR-positive early breast cancer
withneratinib
Dagmar Guth1; Thomas Göhler2; Jörg Bäsecke3; Nils Tribian4;
Corinne Vannier5; Nicolai Maass4; Edgar Petru6
1Gynäkologisch-onkologische Praxis Dr.Guth, Plauen, Deutschland
2Onkozentrum Dresden, Dresden, Deutschland
3St. Josefs-Hospital Cloppenburg, Abteilung Hämatologie, Onkologie und
Palliativmedizin, Cloppenburg, Deutschland
4Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Gynäkologie
und Geburtshilfe, Kiel, Deutschland
5Pierre Fabre Pharma GmbH, Freiburg, Deutschland
6Medizinische Universität Graz, Klinische Abteilung für Gynäkologie,
Graz, Österreich
Background: Neratinib is an oral, irreversible pan-HER TKI approved in
Europe in adult patients (pts) with early-stage hormone receptor positive
(HR+), HER2-positive (HER2+) breast cancer (BC) who completed adju-
vant trastuzumab-based therapy ≤1 year ago. In the phase III ExteNET
study, neratinib showed a signicant 5-year invasive disease-free survival
advantage (Δ5.1%, HR 0.58, 95% CI 0.41-0.82). Without mandated antid-
iarrheal prophylaxis, which is now routinely used in clinical practice, the
most common AE was diarrhea (39% grade 3).
Methods: is project aims to collect 25 retrospective single case reports
of adult pts with HER2+/HR+ early BC treated with neratinib for ≥3
months. It is conducted in up to 25 sites in Germany and Austria. Pts
are selected by the treating physicians according to 5 prespecied case
types (5 pts each) reecting relevant treatment situations, all followed by
extended adjuvant treatment with neratinib:
1. Adjuvant Trastuzumab (T)
2. Adjuvant T+Pertuzumab (P)
3a. pCR aer neoadjuvant T+P, T postneoadjuvant
3b. pCR aer neoadjuvant T+P, T+P postneoadjuvant
4. non-pCR aer neoadjuvant T+P, T-DM1 postneoadjuvant
Eligible pts with signed informed consent are documented in standard-
ized case report forms. e objective is to collect real-world data on nera-
tinib-containing anti-HER2 regimens with focus on neratinib treatment
management.
Result/Current Status: As of August 31, 2023, 8 sites are participating
or agreed to participate in the project in Germany (6 sites) and Austria
(2 sites). End of case report documentation is expected by mid-2024.
Conclusion: is project describes real-world treatment journeys of pts
with eBC treated with extended adjuvant neratinib including patients pre-
treated with the most recent trastuzumab based therapies. e collected
data could serve as basis for medical educational materials and scientic
discussions.
Funding: Study funding by Pierre Fabre.
First published: DGHO 2023
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
196
Long-term Patient-reported Outcomes from monarchE:
Abemaciclib plus Endocrine Therapy for Adjuvant HR+,
HER2−, Node-positive, High-risk, Early Breast Cancer
Nadia Harbeck1; Valentina Guarneri2; Jae Hong Seo3; Josena Cruz4;
Miguel Henriques Abreu5; Masato Takahashi6; Carlos Barrios7;
Kristi Mcintyre8; Ran Wei9; Belen San Antonio9; Astra M Liepa9;
Miguel Martin10; Stephen R.D. Johnston11; Sara M. Tolaney12
1Breast Centre, Department of Gynaecology and Obstetrics, Comprehensive
Cancer Centre München, LMU University Hospital, München, Deutschland
2Instituto Oncologico Veneto IRCCS, Padua, Italien
3Korea University Guro Hospital, Seoul, Republik Korea
4Hospital Universitario de Canarias, Canary Islands, Spanien
5Department of Medical Oncology, Portuguese Institute of Oncology of
Porto, Porto, Portugal
6National Hospital Organization Hokkaido Cancer Center, Hokkaido, Japan
7Hospital São Lucas da PUCRS, Porto Alegre, Brasilien
8Texas Oncology PA, Texas, USA
9Eli Lilly and Company, Indianapolis, USA
10Hospital General Universitario Gregorio Marañon, Universidad Complutense,
CIBERONC, GEICAM, Madrid, Spanien
11Royal Marsden NHS Foundation Trust, London, United Kingdom
12Dana-Farber Cancer Institute, Boston, USA
Background: Abemaciclib demonstrated sustained benet in inva-
sive disease-free survival and a tolerable safety prole in monarchE at
42months (mo) median follow-up (mFU). At 19mo mFU initial patient
(pt)-reported outcome (PRO) ndings supported a tolerable prole with
most remaining on treatment (tx). With all pts now o abemaciclib, we
report data including the full 2year tx period and follow-up to evaluate
long-term impact on PROs.
Methods: Pts completed PROs (FACT-B, FACT-ES, FACIT-Fatigue) at
baseline, 3, 6, 12, 18, 24mo and 1, 6, 12mo aer tx discontinuation (dc).
Mixed eects repeated measures model estimated changes from base-
line within and between arms for summary scores and individual items.
Meaningful change was 0.5 standard deviation of baseline summary
scores and 1 point for individual items. Additional analyses: frequencies
of responses to items associated with adverse events (AEs; eg, diarrhea,
fatigue) and tx bother.
Result: PRO completion rates (5591 treated pts) were >90% on tx and
~80% during follow-up. Within- and between-arms, dierences in mean
changes from baseline for all PROs were less than prespecied thresh-
olds for meaningful dierence, except for diarrhea, with worse scores in
abemaciclib+ET at 3 and 6mo. During tx most pts reported being both-
ered “a little bit” or “not at all” by side eects in both arms and most pts
(79-85%) on abemaciclib reported “not at all” to “somewhat” for diarrhea.
PROs in both arms (post-tx follow-up) were similar to baseline, with
≥80% of pts on abemaciclib arm reporting “not at all” for diarrhea.
Discussion: Adjuvant abemaciclib added to ET did not result in meaning-
ful dierences in PROs, except for diarrhea, which is considered clinically
manageable.
Conclusion: Long-term ndings suggest reversibility of these eects aer
tx dc and can help inform pt risk/benet assessment.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts32
214
ELEVATE: A phase 1b/2, open-label, umbrella study evaluating
elacestrant in various combinations in women and men with
estrogen receptor-positive (ER+), HER2-negative (HER2-)
locally advanced or metastatic breast cancer (mBC)
Hope S. Rugo1; Aditya Bardia2; Javier Cortes3; Giuseppe Curigliano4,5;
Erika Hamilton6; Sara A. Hurvitz7; Sibylle Loibl8,9; Sherko Kümmel10,11;
Simona Scartoni12; Shannon Matheny13; Kathy Puyana Theall13;
Joyce O’shaughnessy14
1University of California San Francisco Comprehensive Cancer Center,
San Francisco, USA
2Massachusetts General Hospital Cancer Center, Harvard Medical School,
Boston, USA
3International Breast Cancer Center, Quiron Group, Barcelona, Spanien
4European Institute of Oncology IRCSS, Milan, Italien
5University of Milano, Milan, Italien
6Sarah Cannon Cancer Institute/Tennessee Oncology, Nashville, USA
7UCLA Jonsson Comprehensive Cancer Center, Los Angeles, USA
8German Breast Group, Neu-Isenburg, Deutschland
9Centre for Haematology and Oncology Bethanien, Frankfurt, Deutschland
10Charité – Universitätsmedizin Berlin, Department of Gynecology with Breast
Cancer, Berlin, Deutschland
11Kliniken Essen-Mitte, Essen, Deutschland
12Menarini Group, Florence, Italien
13Stemline Therapeutics/Menarini Group, New York, USA
14Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, USA
Background: Endocrine therapy (ET) is the mainstay of treatment for
ER+/HER2- mBC; however, ET resistance is common in the metastatic
setting. Aer progression on rst-line treatment, both ET monotherapy
and combination therapy options are available. Combinations such as
everolimus + exemestane and alpelisib + fulvestrant can be associated
with higher ecacy but also signicant toxicity, with discontinuation rates
~25%. For second-line treatment, combining fulvestrant with a CDK4/6i
is a recommended treatment option for CDK4/6i-naive pts (NCCN, 2022).
However, fulvestrant has low bioavailability and an IM injection burden.
e crosstalk between the three pathways ER, PI3K/AKT/mTOR and
cyclin-dependent kinases (CDK4/6) provide rationale for the combina-
tion of elacestrant, a next-generation oral SERD, with PI3K/AKT/mTOR
or CDK4/6 inhibitors to overcome endocrine resistance. e EMERALD
trial reported signicantly prolonged PFS with elacestrant vs SOC ET in
pts with ER+/HER2− ESR1 mutated mBC following disease progression
on prior ET (Bidard, 2022). Elacestrant was well tolerated with a manage-
able safety prole. Most adverse events, including nausea, were low-grade
and consistent with other endocrine therapies. Replacing the fulvestrant
backbone with elacestrant in combination with targeted agents enabling
oral-oral combinations is of therapeutic interest.
Methods: ELEVATE (NCT05563220) is a phase 1b/2 trial evaluating the
safety and ecacy of elacestrant combined with alpelisib, everolimus,
palbociclib, abemaciclib, and ribociclib. Eligible pts must be adults with
conrmed ER+/HER2− advanced or mBC and have > 1 measurable
lesion as per RECIST v1.1. e main objective for Phase 1b is to deter-
mine the RP2D of elacestrant combined with other targeted agents. e
RP2D of elacestrant and abemaciclib will be determined in the ELECTRA
study (NCT05386108). e Phase 2 portion will evaluate the ecacy of
elacestrant combined with other study drugs for PFS; secondary objec-
tives include PK, ORR, DoR, CBR, PFS, and OS. Recruitment is actively
ongoing.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
275
Exploring Double Heterozygosities in Hereditary Breast and
Ovarian Cancer: Advancing Beyond Single Cases through
Comprehensive Analysis
Natalie Herold1; Christoph Engel2; Dorothee Speiser3; Tim Ripperger4;
Andrea Gehrig5; Nadia Harbeck6; Norbert Arnold7; Nicola Dikow8;
Susanne Ledig9; Elena Leinert10; Matthias Rath11; Eric Hahnen1;
Jan Hauke1; Susanne Morlot4; Nina Ditsch12; Julia Ritter13; Britta Blümcke1;
Jörg Schröder5; Anke Waha1; Anna Hester6; Monika Maringa1;
Bernadette Jäger14; Kerstin Rhiem1; Barbara Wappenschmidt1;
Christine Solbach15; Bernhard H.F. Weber16; Tobias Blaum17;
Christopher Schroeder18; Alexander Volk19; Bahriye Aktas20;
Marion Kiechle21; Cornelia Meisel22; Tanja Fehm14; Bernd Auber4;
Rita Katharina Schmutzler1; Monika M. Golas23
1Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology,
Medical Faculty, University Hospital Cologne, Cologne, Deutschland
2Institute for Medical Informatics, Statistics and Epidemiology, Leipzig
University, Leipzig, Deutschland
3Hereditary Breast and Ovarian Cancer Center Charité, Department of
Gynecology with Breast Center, Charité University Medicine Berlin, Berlin,
Deutschland
4Department of Human Genetics, Hannover Medical School, Hannover,
Deutschland
5Institute of Human Genetics, Julius-Maximilians-Universität Würzburg,
Würzburg, Deutschland
6Department of Gynecology and Obstetrics, Breast Center, LMU University
Hospital, Munich, Deutschland
7Department of Gynecology and Obstetrics, Institute of Clinical Molecular
Biology, University Hospital of Schleswig-Holstein, Christian-Albrechts-
University Kiel, Kiel, Deutschland
8Institute of Human Genetics, Heidelberg University, Heidelberg, Deutschland
9Institute of Human Genetics, University of Muenster, Muenster, Deutschland
10Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm,
Deutschland
11Department of Human Genetics, University Medicine Greifswald, Greifswald,
Deutschland
12Department of Obstetrics and Gynecology, University Hospital Augsburg,
Augsburg, Deutschland
13Hereditary Breast and Ovarian Cancer Center Charité, Department of
Gynecology with Breast Center, Charité University Medicine Berlin and Labor
Berlin – Charité Vivantes GmbH, Berlin, Deutschland
14Department of Gynecology and Obstetrics, University Hospital Düsseldorf,
Heinrich-Heine University Düsseldorf and Center for integrated Oncology (CIO)
ABCD, Duesseldorf, Deutschland
15Center for Hereditary Breast and Ovarian Cancer, University Hospital Frankfurt,
Frankfurt, Deutschland
16Institute of Human Genetics, University of Regensburg and Institute of Clinical
Human Genetics, University Hospital Regensburg, Regensburg, Deutschland
17Department of Gynecology and Obstetrics, University Medicine Göttingen,
Goettingen, Deutschland
18Institute of Medical Genetics and Applied Genomics, University of Tübingen,
Tübingen, Deutschland
19Institute of Human Genetics, University Medical Center Hamburg-Eppendorf,
Hamburg, Deutschland
20Department of Gynecology, University of Leipzig Medical Center, Leipzig,
Deutschland
21Department of Gynecology and Center for Hereditary Breast and Ovarian
Cancer, Klinikum rechts der Isar, Technical University Munich, Munich,
Deutschland
22Department of Gynecology and Obstetrics, Technical University Dresden,
Dresden, Deutschland
23Human Genetics, Faculty of Medicine, University of Augsburg, and University
Hospital Augsburg, Augsburg, Deutschland
Background: Risk-adapted surveillance programs and risk-reducing sur-
gery for individuals with hereditary breast and/or ovarian cancer (HBOC)
represent a central advancement in clinical management. While risk-
adapted measures for carriers of a single HBOC-associated (likely) path-
ogenic variant (pV) have been established, that for individuals harboring
pVs in multiple cancer predisposition genes remain unclear.
Methods: Phenotypic traits of double heterozygous (DH) counselees, includ-
ing breast cancer (BC) receptor status, onset, and severity, were compared to
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 33
those of single heterozygous (SH) carriers in the German Consortium for
HBOC (GC-HBOC) registry of more than 27,000 pV carriers.
Result: In total, we identied more than 400 multiple heterozygous coun-
selees. For pV carriers tested for thirteen HBOC core genes, the preva-
lence of multiple heterozygosity was about 3%. BC in double heterozygous
(DH) females displayed a prevalent receptor phenotype, inuenced by
the distinct variant gene combinations. Triple-negative BC was enriched
in most BRCA1-involved gene combinations, as in BRCA1 SH carriers.
However, among BRCA1/CHEK2 DH carriers, BC predominantly exhib-
ited a hormone receptor-positive status. e age at which BC developed in
DH females corresponded to the cancer onset of counselees with a single
pV in the more penetrant gene. Signicantly, BRCA1/BRCA2 DH females
had a higher severity score as compared to BRCA1 or BRCA2 SH carriers.
Discussion: Our results emphasize a more frequent presence of multi-
ple heterozygosity, particularly DH, surpassing previous understanding.
Moreover, we provide evidence to suggest that the presence of a second
pV can inuence the disease prole.
Conclusion: Overall, our data underscore the necessity of taking into
account multiple heterozygosities when making clinical decisions – both
for the index counselees and their family members. Recognizing the
potential impact of multiple pVs on the phenotype could thereby enhance
the provision of more rened and personalized guidance and support.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
280
Information material for counselees, patients and health
professionals: results and lessons learned
Anja Tüchler1; Kristin Leyerer2; Kerstin Rhiem1; Susanne Weg-Remers2;
Rita Katharina Schmutzler1
1Zentrum Familiärer Brust- und Eierstockkrebs Uniklinik Köln, Köln, Deutschland
2Krebsinformationsdienst, Deutsches Krebsforschungszentrum, Heidelberg,
Deutschland
Background: Continuous advances in genetic testing in the context of
familial breast and ovarian cancer pose major communication challenges
for patients and health professionals. In addition, limited self-reported
health literacy was observed in the majority of the German population. To
address these issues, the Center for Hereditary Breast and Ovarian Cancer
and the Cancer Information Service developed information brochures for
both patients and health professionals within the “Innovative Partnership
for Action Against Cancer”(iPAAC) initiative.
Methods: Interviews and surveys were conducted to address the tar-
get groups’ needs. Complementary brochures for patients/counselees
and health professionals were developed, considering the current evi-
dence-based knowledge on familial breast and ovarian cancer. e bro-
chures for counselees/patients were written in easy and plain language,
respectively. e nal brochures are evaluated by the target groups in
user-tests.
Result: Within the project, ve brochures for patients/counselees (easy
and plain language) and health professionals were developed. Results of
user-testing will be presented. e results have been previously presented.1
Discussion and Conlusion: e brochures developed are aimed to
be disseminated within the 23 centers of the German Consortium for
Hereditary Breast and Ovarian Cancer and its > 200 cooperating certi-
ed breast and gynaecological cancer centers in Germany. In addition,
the Cancer Information Service will distribute the material online via its
well-established information channels.
Indication of source:
1 A. Tüchler et al. Information material for counselees, patients and health
professionals: results and lessons learned [abstract]. In: Abstract Book of
the 3rd International Conference on Cancer Prevention; 2022 Oct 26–27;
Heidelberg. Heidelberg: DKFZ; 2022. Abstract nr 27.
Disclosure Statement: e authors declare no conict of interest.
295
T helper cell response in seroma uid after breast cancer
surgery – results of the SerMa pilot study
Nicole Pochert1,2; Melitta Köpke2; Mariella Schneider2; Mathis Wild2,3;
Monika Golas4; Aline Metz1; Ludwig Christian Hinske3; Matthias Reiger1;
Udo Jeschke2; Christian Dannecker2; Claudia Traidl-Homann1;
Michael Untch5; Thorsten Kühn6; Nina Ditsch2
1Umweltmedizin, medizinische Fakultät, Universität Augsburg, Augsburg,
Deutschland
2Universitätsklinikum Augsburg, Klinik für Frauenheilkunde und Geburtshilfe,
Augsburg, Deutschland
3Department of Data Management and Clinical Decision Support, medizinische
Fakultät, Universität Augsburg, Augsburg, Deutschland
4Lehrstuhl für Humangenetik, medizinische Fakultät, Universität Augsburg,
Augsburg, Deutschland
5Helios Klinikum Berlin-Buch, Klinik für Frauenheilkunde und Geburtshilfe,
Berlin, Deutschland
6Filderklinik, Klinik für Frauenheilkunde und Geburtshilfe, Esslingen,
Deutschland
Background: Seroma formation is one of the most frequent complications
aer breast cancer surgery, especially aer simple mastectomy. e aim of
the SerMa pilot study was to investigate immunological processes respon-
sible for seroma formation. Identication and characterization of immune
cell populations as well as specic immune reactions found in seroma
uids (SFl) and peripheral blood (PB) of patients aer breast cancer sur-
gery were therefore the main points of interest.
Methods: Flow cytometry analyses of SFl from breast cancer patients who
developed seroma aer surgery were performed to identify the immune
cell content. Immune cells were measured in comparison to PB of the
same patient and in contrast to healthy controls.
Result: Granulocytes and Monocytes were signicantly reduced in SFl
compared to PB of patients and healthy controls, while lymphocytes were
signicantly elevated. Within the lymphocyte compartment B cells, NK
cells and cytotoxic T cells were signicantly reduced in SFl. In contrast,
T-helper cells – primarily 2 and 17 were signicantly elevated in SFl
as well as in PB of patients compared to controls. 22 and Treg showed
signicant higher values in SFl compared to PB (patients and healthy con-
trols). In addition, cells with the activation marker HLA-DR on their sur-
face were measured in signicantly higher percentages in SFl and PB of
patients compared to controls, whereas naïve cells were reduced.
Discussion: Within our SerMa pilot study, we were able to identify a spe-
cic immune response in breast cancer patients with seroma formation.
We succeeded in identication of a general upregulation of T-helper cells
in SFl, whereas other immune cells have been decreased. 2 and 17 are
both known as marker for regulation of immune responses.
Conclusion: e signicant increase of 2/17 cells in patients could
be potential biomarkers for seroma formation. e detection of these
specic immune cell changes in SFl indicate an inammatory response,
also shown by the increased presence of HLA-DR+ cells and reduction
of naive cells.
Disclosure Statement: e authors declare no conict of interest.
326
Urinalysis of breast cancer patients identies disease-specic
miRNA patterns
Jochen Maurer; Elmar Stickeler
Uniklinik RWTH Aachen, Gynäkologie und Geburtsmedizin, Aachen,
Deutschland
Background: One in eight women will suer from breast cancer. Markers,
ideally non-invasive, for early detection, diagnosis and progression mon-
itoring are key in future therapy. Small RNA molecules, like miRNAs, are
very stable in almost all body uids and could serve as these sought-aer
markers.
Methods: Using an isolation of total miRNA from 4 milliliters of urine
samples (slightly less than a teaspoon), 82 women (50 healthy individuals
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts34
and 32 breast cancer patients) were studied using miRNA-sequencing to
determine whether consistent patterns of miRNA regulation could be
found despite this small amount.
Result: From a still small group of patients we generated the rst data
using miRNA chip analysis, but these are already very promising for the
possibility of valid testing of the disease by urinalysis. e primary goal
was to validate the patterns found in a larger group of patients. erefore,
we subsequently validated and evaluated the recently tested method of
miRNA sequencing in our clinic on the larger (82) sample cohort and
investigated to what extent the predictive power for breast cancer sub-
type patterns of miRNAs holds up or can even be improved in this larger
cohort. e sequencing analysis reliably detected over 4000 individual
miRNAs in each patient. Analysis revealed subcategory specic miRNA
patterns that allowed us to stratify patients according to urinalysis.
Discussion: Our data indicate that urinalysis could be a valuable tool
in the non-invasive detection and monitoring of breast cancer patients.
Clearly this rst patient cohort is still too small to make predictions for
the disease as a whole but the distinct patterns of breast cancer subclasses
with only very few overlapping miRNAs between them makes a prognos-
tic value for these analyses highly likely.
Conclusion: We identied miRNA patterns in small urine samples from
breast cancer patients by using miRNA sequencing with Random for-
est analysis allowing us to distinguish healthy individuals from cancer
patients.
Disclosure Statement: e authors declare no conict of interest.
346
Genetic Testing Rate in Real World – Data from a large
University Breast Center
Carina Meyer; Nanette Kalmbach; Nora Amirpour-Mehrhof; Sarah Kelch;
Jenny Katharina Wagner; Nicole Zilski; Jens-Uwe Blohmer; Dorothee
Speiser
Charité - Universitätsmedizin Berlin, Campus Mitte, Klinik für Gynäkologie mit
Brustzentrum, Berlin, Deutschland
Background: is study aimed at identifying the rate of genetic
germline analyses and detected pathogenic germline variants in breast
cancer patients fullling either the family history criteria of Deutsche
Krebsgesellscha (DKG) or indication of targeted therapy.
Methods: Anonymized real-world patient data from Charité -
Universitätsmedizin Berlin from 2018-2022 were used for retrospective
analysis. Apart from indication, timing, and outcome of germline genetic
analysis, patients’ age, family history (using DKG checklist score), disease
progression and tumor characteristics (staging, HR/HER2 status, metas-
tasis), were analyzed. Data collection and analysis is currently underway
and will be completed in October 2023. Chi-square tests and Mann-
Whitney U tests were used to compare patients in dierent groups and to
analyze the dependencies of variables.
Result: e cohort consisted of n = 1535 breast cancer patients who pre-
sented at Charité - Universitätsmedizin Berlin between 2018 and 2022.
Of these, 384 (25%) receive a germline analysis and 1151 (75%) were
not tested on germline variants. Of the patients who received a germline
analysis, 173 (45%) were carriers of a pathogenic germline variant in one
of the actionable core genes. Full results on the prevalence and role of
germline analysis will be presented at the conference in 2024.
Discussion: e outcomes suggest less than optimal testing rates for
patients. is study could help to improve clinical practice in the treat-
ment of breast cancer and thus optimize the process of care. Furthermore,
the results could lead to better risk assessment and counseling of aected
patients.
Conclusion: Knowledge about pathogenic germline variants is important
for risk adapted screening and prevention of breast cancer and can also
decide on the use of targeted therapies in breast cancer patients.
Disclosure Statement: e authors declare no conict of interest.
364
Genotype-phenotype-association of common pathogenic
variants in BRCA1
Anna Knödler1; Nanette Kalmbach1; Julia Ritter2; Susanne Herbst2; Jenny
Katharina Wagner1; Nicole Zilski1; Jens-Uwe Blohmer1; Dorothee Speiser1
1ZFBREK; Charité - Universitätsmedizin Berlin, Berlin, Deutschland
2Labor Berlin – Charité Vivantes GmbH, Berlin, Deutschland
Background: Patients who carry a pathogenic germline BRCA1 variant
have higher risks to get breast or ovarian cancer in comparison to non-
carriers. Earlier studies showed that there is a genotype-phenotype corre-
lation depending on type and location of the pathogenic variant in BRCA1,
so that there might be a dierent clinical approach. e goal of this study
was to try to reproduce these results on data from the Hereditary Breast
and Ovarian Cancer Center at Charité Berlin.
Methods: is is a retrospective observational study with data of the
Hereditary Breast and Ovarian Cancer Center at Charité Berlin from 2016
to 2023. 628 patients (n=628) carrying a pathogenic or likely pathogenic
variant (ENIGMA classication V/IV) in BRCA1 were included in the
analysis. Patients were divided into groups, depending on the specic var-
iant and compared for age of onset, histology of tumors, further pheno-
typical characteristics and follow up. e data is currently being analysed
and exact results are expected for January 2024.
Result: Out of the 628 patients 294 (47%) already had a diagnosis of breast
cancer, 169 (26%) already had a diagnosis of ovarian cancer and 182 (29%)
were healthy at the time of counselling. Most of the patients carried the
BRCA1 founder mutation c.5266dupC, followed by the BRCA1 variants
c.4035delA and c.2411_2412delAG. Whether these variants dier in their
phenotypical characteristics will be shown in the nal presentation at the
conference.
Discussion: Results from our analysis will be compared to former studies
and presented in the conference.
Conclusion: is data could have an impact on risk counselling, risk
adapted screening and prevention as well as clinical treatment options
and life perspectives of patients and counselees carrying a pathogenic
germline variant in BRCA1 variant.
Disclosure Statement: e authors declare no conict of interest.
402
The SURVIVE-HERoes trial – a secondary adjuvant treatment
intervention study with trastuzumab-deruxtecan in early
breast cancer patients with HER2 positive/HER2 low tumors
and a molecular relapse based on a ctDNA-liquid biopsy
approach
Franziska Mergel1; Sophia Huesmann1; Kerstin Pster1; Angelina Fink1;
Henning Schäer1; Forca Mehmeti1; Tanja Fehm2; Volkmar Müller3;
Klaus Pantel4; Thomas W. P. Friedl1; Lisa Wiesmüller1; Ramona Erber5;
Arndt Hartmann5; Matthias Beckmann6; Peter Andreas Fasching6;
Andreas Hartkopf7; Brigitte Rack1; Wolfgang Janni1
1Klinik für Frauenheilkunde und Geburtshilfe (Frauenklinik) -
Universitätsklinikum Ulm, Ulm, Deutschland
2Universitätsklinikum Düsseldorf Klinik für Frauenheilkunde und Geburtshilfe,
Düsseldorf, Deutschland
3Universitätsklinikum Hamburg-Eppendorf Klinik und Poliklinik für Gynäkologie,
Hamburg, Deutschland
4Universitätsklinikum Hamburg-Eppendorf Center for experimental medicine,
Hamburg, Deutschland
5Universitätsklinikum Erlangen Institut für Pathologie, Erlangen, Deutschland
6Universitätsklinikum Erlangen Frauenklinik, Erlangen, Deutschland
7Universitätsklinikum Tübingen Frauenklinik, Tübingen, Deutschland
Background: In the new era of highly eective antibody drug conjugates
(ADC), secondary adjuvant (adj.) treatment options for early breast can-
cer (EBC) patients at a high risk of relapse arise. e ADC trastuzum-
ab-deruxtecan (T-DXd) has shown promising ecacy in patients with
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 35
HER2-positive and HER2-low metastatic breast cancer and is currently
tested in the post-neoadjuvant setting in patients with non-pCR. To
successfully apply ADCs as a secondary adj. treatment, identication of
patients who would benet the most is required. e detection of minimal
residual disease (MRD) using liquid biopsy, e.g. ctDNA, may oer a prom-
ising approach for patient selection. e ecacy of such a secondary adj.
treatment in terms of delaying or preventing distant metastases has yet to
be evaluated in a randomized trial.
Methods: e SURVIVE-HERoes trial is a prospective, randomized, open
label comparative Phase III superiority trial in patients with intermediate
to high-risk HER2-positive or HER2-low EBC. Patients have completed
primary breast cancer therapy and participate in the large breast cancer
surveillance trial SURVIVE (NCT05658172) and experience a molecu-
lar relapse, determined by a positive ctDNA result and negative imaging.
Patients will be randomized (2:1 allocation) to treatment with T-DXd ver-
sus standard of care for 12 months, ctDNA levels will be tested repeatedly.
e primary objective is the comparison of ctDNA clearance rates aer
6 months. Secondary objectives include overall survival, invasive dis-
ease-free survival, distant disease-free survival, quality of life and safety
of T-DXd.
Result: n/a
Conclusion: is trial is a proof of principle study with the aim to estab-
lish the ecacy of secondary adj. treatment with T-DXd in patients with
HER2-positive/HER2-low EBC, who are at high risk of relapse, as evi-
denced by detection of ctDNA. If successful, it could lead to a treatment
shi towards early intervention with secondary adj. targeted therapies fol-
lowing liquid-biopsy based MRD detection.
Disclosure Statement: e authors declare no conict of interest.
453
Analysis of Guideline Quality Indicator 8 - Radiation Therapy
after Breast Conservation Therapy - in the Cancer Registry
Mecklenburg-Western Pomerania
Gabriele Robers; Kerstin Weitmann; Kirsi Manz; Wolfgang Homann
Krebsregister Mecklenburg-Vorpommern, Institut für Community Medicine,
Universitätsmedizin Greifswald, Greifswald, Deutschland
Background: In 2022, analyses on the fulllment of the quality indica-
tors (QI) of the S3 guideline of breast cancer2 were presented at the 4th
Statewide Quality Conference of the Cancer Registry Mecklenburg-
Western Pomerania. It was investigated whether treatment according
to QI 8 (radiotherapy (RT) aer breast-conserving therapy (BCT)) has
an inuence on the overall survival of female patients in Mecklenburg-
Western Pomerania (M-V).
Methods: Patients with non-metastatic invasive breast cancer diagnosed
or treated in M-V between 2017 and 2021 were included in the analysis.
RT aer BCT (QI 8) was evaluated annually, considering the calculation
rules agreed among all clinical cancer registries according to §65c SGBV1.
Kaplan-Meier curves and Cox proportional hazards model (HR) were
used to evaluate the impact.
Result: Over the years, fulllment of QI 8 improved (2017: 84.1%, 2021:
90.4%). e absolute 3-year survival rate (SR) of patients with RT aer
BCT was 0.97 (95% condence interval (CI): 0.97 - 0.98), showing a sur-
vival advantage over patients without RT aer BCT (SR 0.89, CI: 0.86
- 0.92). e age-adjusted Cox-model showed a signicant eect of fulll-
ment QI 8 (HR 3.25, CI: 2.24 - 4.71, p<0.01).
Discussion: e eect of RT aer BCT must be veried by including other
factors such as grading or general condition of the patients.
Conclusion: e degree of fulllment of QI 8 of the S3 guideline of breast
cancer has increased over time in female patients in M-V. Among patients
meeting QI 8, absolute 3-year survival was signicantly longer compared
by patients without radiotherapy. Monitoring of QI and their presentation
at quality conferences are useful to further improve the quality of onco-
logical care.
Indication of source:
1 https://conuence.basisdatensatz.de/pages/viewpage.action?pageId=2820621,
Accessed 25.08.2023.
2 German Cancer Society, German Cancer Aid, AWMF: Interdisciplinary
Evidenced-based Practice Guideline for the Early Detection, Diagnosis,
Treatment and Follow-up of Breast Cancer, Version 4.4, 2021, AWMF
Registration Number: 032/045OL.
Disclosure Statement: e authors declare no conict of interest.
483
Exploring Mobile Health Apps for Breast Cancer Prevention
and Education: An In-depth Analysis of Features, Quality,
and Functionality
Stefanie Altmannshofer1,2,3; Madeleine Flaucher4; Milena Beierlein1,2,3;
Bjoern Eskoer4; Matthias Beckmann1,2,3; Peter Andreas Fasching1,2,3;
Hanna Hübner1,2,3
1Department of Gynecology and Obstetrics, Erlangen University Hospital,
Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen,
Deutschland
2Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-
Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
3Bavarian Cancer Research Center (BZKF), Erlangen, Deutschland
4Machine Learning and Data Analytics Lab, Friedrich-Alexander-Universität
Erlangen-Nürnberg (FAU), Erlangen, Deutschland
Background: Digital tools, such as mobile Health (mHealth) applications
(apps), are meanwhile widely accepted as necessary and popular resources
for the distribution of information and education by providing a variety
of functionalities and benets, such as tailored health information or real-
time monitoring of health behaviors. e aim of this study was the analy-
sis of features, quality and functionality of apps designed for breast cancer
prevention.
Methods: We systematically searched the Google Play and Apple App
Stores for apps addressing breast cancer topics. Apps were categorized in
ve groups: 1) prevention and enlightenment, 2) therapy, 3) aercare, 4)
for professionals and 5) others. ose assorted to the category “preven-
tion” were downloaded and analysed using the Mobile Application Rating
Scale (MARS). App characteristics were examined and associated with
MARS scores.
Result: e Google Play and Apple App Store search identied 391 and
189 apps, respectively. 89 and 38 apps were categorized as “prevention, 44
and 32 as “therapy”, 6 and 22 as “aercare, 9 and 5 as “for professionals
and 50 and 29 apps as “others, respectively. Aer removing duplicates,
53 and 20 apps remained in the category “prevention. 19 and 7 apps were
analysed using MARS. e mean MARS scores were 3.07 (Google Play
Store) and 3.50 (Apple App Store). All MARS categories were signicantly
associated with apps developed by Health Organizations.
Discussion: More than 60% of the apps originated from sources with
questionable legitimacy or trustworthiness. Our data indicates that apps
developed in collaboration with health care professionals are of higher
quality.
Conclusion: Our study underscores both the potential and challenges of
mHealth apps for breast cancer prevention. Future eorts should prior-
itize collaboration with health care professionals, ensuring app legitimacy,
and continuing to enhance app quality, with the goal to provide valuable
tools for breast cancer prevention and enlightenment.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts36
484
RESCUER – Data harmonization of multiple clinical
trials – challenges and chances
Sarah Lehle1,2,3; Mathias Ernst1,2,3; Fara Brasó-Maristany4,5; Aleix Prat4,5,6;
Olav Engebraten7,8,9; Thomas Hatschek10,11; Theodoros Foukakis10,11;
Jon Amund Kyte2,12; Matthias Rübner1,2,3; Sabrina Uhrig1,2,3;
Matthias Beckmann1,2,3; Peter Andreas Fasching1,2,3;
Vessela N. Kristensen13,14; Hanna Hübner1,2,3,15
1Bavarian Cancer Research Center (BZKF), Erlangen, Deutschland
2Department of Gynecology and Obstetrics, University Hospital Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen,
Deutschland
3Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-
Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
4Department of Medical Oncology, Hospital Clínic, Barcelona, Spanien
5Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i
Sunyer Biomedical Research Institute, Barcelona, Spanien
6SOLTI Breast Cancer Research Group, Barcelona, Spanien
7Department of Tumor Biology, Oslo University Hospital Oslo, Oslo, Norwegen
8Department of Oncology, Oslo University Hospital, Oslo, Norwegen
9Insitute for Clinical Medicine, University of Oslo, Oslo, Norwegen
10Breast Cancer Center, Karolinska University Hospital, Stockholm, Schweden
11Department of Oncology-Pathology, Karolinska Institutet, Stockholm,
Schweden
12Department of Cancer Immunology, Institute for Cancer Research, Oslo
University Hospital, Oslo, Norwegen
13Department of Medical Genetics, Oslo University Hospital, Oslo, Norwegen
14Institute of Clinical Medicine, University of Oslo, Oslo, Norwegen
15Institut für Frauengesundheit GmbH, Erlangen, Deutschland
Background: e EU Horizon 2020 project RESCUER aims to investigate
tumor-specic mechanisms of treatment resistance with focus on targeted
therapies. Within multiple European clinical trials, the project is gather-
ing and integrating multidimensional data but also generating multi-omic
data. is data will be used to feed computational networks and create
in silico models to discover molecular signatures of resistance and pre-
dict response to therapies. To overcome the diering presentation of data
across clinical trials and nd similarities, data organization, -cleaning and
-integration are needed.
Methods: Clinical data from eight European trials was transferred to
a central data management unit and stored in a single database on MS
SQL Server 2016. For data integration into one data base an Extract-
Transform-Load (ETL) process was established. Due to heterogeneity, the
ETL processes had to be tailored to each individual dataset. To harmo-
nize the clinical variables of each study were translated into a xed master
dictionary.
Result: To ensure data privacy, each data transfer was regulated by trans-
fer agreements, data was anonymized and ethics committee approvals
were obtained. Other challenges included data heterogeneity and missing
data. Variables were coded dierently between trials or had to be calcu-
lated from multiple variables. Technical compatibility was an issue, as data
were submitted in various le formats. Out of eight datasets, one was sub-
mitted as a text le, ve as Excel les and two as SQL datasets, which made
preprocessing and transformations necessary. Data combination resulted
in a sample size of 1843 patients with 1200 hormone receptor positive and
HER2 negative, three HER2 receptor positive, 566 triple negative patients.
Discussion: Combing data sets is challenged by big organizational eort,
missing guidelines on data presentation and the need for data manage-
ment knowhow.
Conclusion: Overcoming the data heterogeneity can improve statisti-
cal power by combining data sets, and is essential to discovering eects
eciently.
Disclosure Statement: e authors declare no conict of interest.
537
Clinical results of the SerMa pilot study: Elderly and Patients
with Large Breast Volume Have an Increased Risk of Seroma
Formation after Mastectomy
Melitta Köpke1; Mathis Wild1,2; Mariella Schneider1; Nicole Pochert1,3;
Jacqueline Sagasser1; Felicitas Schneider1; Thorsten Kühn4,5;
Michael Untch6; Christian Ludwig Hinske2; Matthias Reiger3;
Claudia Traidl-Homann3; Christian Dannecker1; Udo Jeschke1;
Nina Ditsch1
1University Hospital Augsburg, Departement for Gynecology and Obstetrics,
Augsburg, Deutschland
2Institute for digital medicine, University Augsburg, Augsburg, Deutschland
3Environmental Medicine, University Augsburg, Augsburg, Deutschland
4Filderklinik, Clinic for Gynecology and Obstetrics, Filderstadt-Bonlanden,
Deutschland
5University Hospital Ulm, Department of Gynecology and Obstetrics, Ulm,
Deutschland
6Helios clinic Berlin-Bruch, Obstetrics and Gynecology, Berlin, Deutschland
Background: e pathophysiology behind seroma formation as common
postoperative complication aer ablative procedures for breast cancer is
poorly understood. In the clinical evaluation of the SerMa (Seroma for-
mations of the Mammary gland) pilot study, which investigates primarily
possible immunological or inammatory causes of seroma formation,
clinicopathological correlations between seroma formation and tumor
biology or lymph node involvement were analyzed and are presented here.
Methods: e collective of the SerMa pilot study included 100 cases of
primary breast cancer or carcinoma in situ who had undergone a mas-
tectomy procedure with or without implant-based reconstruction at
Augsburg University Hospital between 12/2019 and 12/2022.
Result: Seroma occurred signicantly more oen in older patients (median
age in cases with seroma 73 years vs. 52 years without seroma; p < 0.001).
In addition, patients with larger mastectomy specimen were signicantly
more likely to develop seroma (median weight in cases with seroma 580 g
vs. 330 g without seroma; p < 0.001). Other signicant parameters for
seroma formation were BMI (p = 0.005), grading (p = 0.015) and tumor
size (p = 0.036). Interestingly, with insertion of implant or expander, ser-
oma occurred signicantly less frequently (p < 0.001). In contrast, tumor
biological characteristics, number of lymph nodes removed or aected
showed no signicant eect on seroma formation.
Discussion: In the present study, there was no signicant inuence of
axillary tumor burden or tumor biologic characteristics on seroma forma-
tion. Since older patients in particular were at risk for seroma formation,
the present study shows the need for patient education in older patients
and patients with large breast volumes within the preoperative surgical
clarication.
Conclusion: ese clinicopathological data support the previously pub-
lished results hypothesizing that seroma formation is related to immuno-
logical processes and will be tested on a larger collective in the planned
international multicenter SerMa study (EUBREAST 5).
Disclosure Statement: e authors declare no conict of interest.
577
Diagnostic yield and clinical relevance of expanded germline
genetic testing for HBOC patients
Jan Henkel1; Andreas Laner1,2; Melanie Locher1,2; Tobias Wohlfrom1;
Birgit Neitzel1; Kerstin Becker1,2; Teresa Neuhann1,2; Angela Abicht1,2,3;
Verena Steinke-Lange1,2; Elke Holinski-Feder1,2,4; Nasge Konsortium2
1MGZ – Medizinisch Genetisches Zentrum, München, Deutschland
2NASGE, Nationale Allianz für seltene genetische Erkrankungen, Hannover,
Deutschland
3Friedrich-Baur-Institute, Department of Neurology, Klinikum der Universität,
Ludwig-Maximilians-Universität, München, Deutschland
4Department of Medicine IV, Klinikum der Universität, Ludwig-Maximilians-
Universität, München, Deutschland
Background: Although there are recommendations at national and interna-
tional level as to which genes should be analyzed in the context of a hereditary
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 37
breast and ovarian cancer (HBOC), the individual composition of the corre-
sponding gene panels varies, resulting in a dierent diagnostic yield.
Methods: We performed a retrospective analyzed NGS Datasets of sus-
pected HBOC patients who had been tested at various German diagnostic
laboratories that are part of the NASGE network and compared the most
common panel recommendations and an internal HBOC core gene panel
with each other. Additionally, we analyzed the data concerning other
potential tumor risk syndromes (TRS) not caused by pathogenic variants
in the core panel genes.
Result: We collected 29,317 HBOC datasets from various German
diagnostic laboratories. At least one pathogenic variant (class 4/5) was
reported in about 4000 datasets, resulting in a diagnostic yield of 14.5%.
We compared our internal HBOC core gene panel to one national and
dierent internationally recommended gene panels. e resulting diag-
nostic yield of pathogenic variants (class 4/5) varied from 9.0% to 13.8%
depending on the panel evaluated, with the internal panel having a yield
of 12.7%. In about 1%, a pathogenic variant outside the established HBOC
core genes was identied, leading to a TRS diagnosis.
Discussion: ese results are consistent with previous observations that
a signicant proportion of patients with hereditary cancer predisposition
were not detected by the guideline-based gene panels and suggest that
expanded diagnostics compared to currently recommended multigene
panels may identify additional patients at high risk for developing cancer.
Conclusion: We suggest to follow-up a medium sized core panel by a com-
prehensive cancer panel to identify additional TRS in patients referred
to HBOC testing, which would not have been detected by current rigid
guideline-based testing.
Disclosure Statement: e authors declare no conict of interest.
624
Empowering Cancer Care: Feasibility and Acceptance of
a Digital Home-Based Health Care Monitoring System for
CDK4/6 Inhibitor Therapy
Hanna Hübner1,2,3; Lena Wurmthaler1,2,3; Chloë Goossens1,2,3;
Mathias Ernst1,2,3; Katharina Seitz1,2,3; Matthias Rübner1,2,3;
Matthias Beckmann1,2,3; Peter Andreas Fasching1,2,3
1Bavarian Cancer Research Center (BZKF), Erlangen, Deutschland
2Department of Gynecology and Obstetrics, University Hospital Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen,
Deutschland
3Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnbergy, Erlangen, Deutschland
Background: Systemic cancer therapies oen lead to side eects that
require regular monitoring. e integration of real-time remote monitor-
ing by using e-health technologies has the potential to enhance cancer
care and to empower patients. e purpose of the SMILER study was to
assess the feasibility and acceptance of a digital home-based health care
system (DHHC).
Methods: e SMILER study (“Smart and Interactive Home Based Health
Care Project – A Digital Healthcare Feasibility Pilot Study Including the
d.H2C2 Initiative”) enrolled patients diagnosed with HR+, HER2-breast
cancer receiving cyclin-dependent kinase (CDK) 4/6 inhibitor treat-
ment. Study participants were provided with a DHHC setup. Data from
home-based measurements, including white blood cell (WBC) counts,
electrocardiograms (ECGs), quality of life questionnaires, and photo doc-
umentation, were collected at scheduled time points. Technical issues,
adherence rates, user perceptions, and acceptance were evaluated through
questionnaires and data analysis.
Result: 76 patients participated in the study, with a mean age of 59 years. e
average adherence to scheduled remote visits were of 43% and 26% on day
14 and day 28, respectively. Participants generally found the DHHC easy to
use, integration into daily life was well-perceived, and willingness to continue
using such a system was expressed. Correlations between home-based and
routine measurements for WBC counts and ECG values were signicant.
Discussion: is study demonstrated a high acceptance of the DHHC for
cancer care. Technical challenges and adherence issues were encountered,
emphasizing the need for ongoing renement and support to ensure eec-
tive implementation.
Conclusion: e positive feedback and acceptance from participants in
this study highlighted the relevance and potential of such digital solutions.
Further research is warranted to evaluate the impact of these interven-
tions on patient outcomes and healthcare resource utilization.
Disclosure Statement: e authors declare no conict of interest.
661
Exploring Personalized Medicine in Breast and Gynecologic
Cancer: Unveiling the Molecular Landscape and Patient
Outcomes from the Molecular Tumor Board Freiburg (MTB-FR)
Using Real-World Data
Linda Gräßel1,2; Johannes Jung1,3,4; Patrick Metzger5; Dorothee Jakob6;
Marlene Mathis6; Thomas Pauli5; Michael Kruszewski2; Mehtap Yücel2;
Michaela Bossart6,7; Thalia Erbes6; Silke Lassmann8,9; Cornelius Miething2,9;
Heiko Becker2,9; Ingolf Juhasz-Böss6; Martin Werner8,9; Justus Duyster1,2,9;
Mtb-Fr Network9; Florin-Andrei Taran6; Melanie Börries1,5,9; Lena Illert1,2,3,4,9
1German Cancer Consortium (DKTK) and German Cancer Research Center
(DKFZ), Heidelberg, Deutschland
2Department of Hematology, Oncology, and Stem Cell Transplantation, Faculty
of Medicine, Freiburg University Medical Center, Freiburg, Deutschland
3Center for Personalized Medicine, Klinikum r.d. Isar, Technical University
Munich, München, Deutschland
4Clinic and Polyclinic for Hematology and Oncology, Faculty of Medicine,
Technical University of Munich, München, Deutschland
5Institute of Medical Bioinformatics and Systems Medicine, Freiburg University
Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
Deutschland
6Department of Obstetrics and Gynecology, Faculty of Medicine, Freiburg
University Medical Center, Freiburg, Deutschland
7Clinic for Obstetrics and Gynecology, St. Josefskrankenhaus, Freiburg,
Deutschland
8Department of Pathology, Faculty of Medicine, Freiburg University Medical
Center, Freiburg, Deutschland
9Comprehensive Cancer Center Freiburg, Faculty of Medicine, Freiburg
University Medical Center, Freiburg, Deutschland
Purpose: e primary goal of the Molecular Tumor Board Freiburg
(MTB-FR) is to identify and evaluate potential molecular targets for
personalized therapeutic approaches in advanced cancer patients who
are particularly young, show surprising disease progression or response
under therapy and/or are faced with limited conventional treatment
options. Breast cancer is the most common cancer worldwide and, based
on current incidence rates, statistically one in eight women in Germany
will develop breast cancer in her lifetime.
Advances in research and early detection, along with improved targeted
therapies, have signicantly improved the prognosis for these patients.
However, breast cancer remains a leading cause of cancer-related death in
women and a signicant contributor to female morbidity and mortality.
e aim of this study is to report the patient characteristics, molecular
landscape, and clinical outcomes of the breast and gynecologic cancer
patients discussed at the MTB-FR between 2015 and 2022.
Methods: All patients diagnosed with breast or gynecologic cancer
between 2015 and 2022 and enrolled in the MTB-FR registry study were
included in this ongoing comprehensive analysis of molecular genetic,
histopathologic, demographic, and outcome data.
Results: Data analysis is currently in progress and nal results will be pre-
sented at the conference.
Discussion: Beyond its immediate impact on patient care, the Molecular
Tumor Boards hold a signicant role in scientically evaluating the
molecular landscape and the therapeutic responses of patients undergoing
targeted treatments. is contributes to a reverse-translation process that
informs the development of future therapies and facilitates the initiation
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts38
of molecularly tailored clinical trials. e primary objective is to provide
an in-depth characterization of the molecular landscape and clinical out-
comes of the breast cancer and gynecological tumor patients discussed at
the MTB-FR from 2015 to 2022, with the intent of sharing these insights
at the conference.
Disclosure Statement: e authors declare no conict of interest.
719
Toxicity and health-related quality of life (HRQOL) outcomes
after intraoperative radiotherapy (IORT) as a boost
compared to simultaneous integrated boosts (SIB) after
breast-conserving therapy for breast carcinoma
Raluca G. Stoian1,2; Jan-Philipp Exner1; Mark Gainey1; Thalia Erbes3;
Eleni Gkika1; Ilinca Popp1; Simon Kb Spohn1; Ingolf Juhasz-Böss3;
Anca-L. Grosu1,2; Tanja Sprave1,2
1Universitätsklinikum Freiburg -Klinik für Strahlenheilkunde, Freiburg im
Breisgau, Deutschland
2German Cancer Consortium (DKTK), partner site DKTK-Freiburg, Deutschland,
Freiburg im Breisgau, Deutschland
3Universitätsklinikum Freiburg Klinik für Frauenheilkunde, Freiburg im Breisgau,
Deutschland
Background: Adjuvant whole breast irradiation (WBI) aer breast-
conserving surgery (BCS) signicantly reduces the risk of local recurrence
and increases overall survival. Tumor bed boost additionally reduces the
risk of local recurrence. e aim of this retrospective analysis was to com-
pare acute and chronic toxicity and health-related quality of life (HRQOL)
aer intraoperative boost application (IORT) and simultaneous integrated
boost (SIB) for WBRT aer BEO.
Methods: 120 patients with breast carcinoma were treated by IORT or WBI
with SIB at the University Freiburg: IORT 1x20 Gy and WBI 50 Gy in 25 or
40.05 in 15 fractions vs. WBI 50 Gy plus SIB 60 Gy in 25 fractions. Toxicity
was compared in a collective created using propensity-score-matching
analysis. HRQOL was assessed using the validated EQ5D-5L questionnaire
before the start and end of therapy and at the rst follow-up. Dierences in
HRQOL within and between groups were analyzed by Kurskall-Wallis test
and Mann-Whitney U test.
Result: 1:1 propensity-score matching resulted in an IORT and SIB
cohort of 60 patients each. e most common acute adverse event
in both groups was radiodermatitis without a signicant dierence
(p=0.309). Signicantly higher fatigue grade 1 was shown in IORT cohort
with 13 (21.7%) vs SIB cohort with 4(6.7%) (p=0.041). Intramammary
lymphedema grade 1 occurred signicantly more oen in the IORT group
with 7(11.7%) vs 1(1.7%) in the SIB group (p=0.026). Both groups showed
comparable late toxicity. In the IORT, HRQOL at therapy start, end and
rst follow-up were respectively: 0.908, 0.852 and 0.928 vs. the SIB group:
0.922, 0.857 and 0.876. HRQOL change within the IORT group and SIB
group was signicant with p=0.005 each. No signicant dierences in
HRQOL were detected between both groups at all time points.
Conclusion: Dose boost in the tumor bed using IORT and SIB techniques
aer BCS achieves comparable good local control and late toxicity. Both
techniques also show a similar trajectory of HRQOL although IORT
application shows a moderate increase in acute toxicity.
Reference:
1 Senologie Kongress 2023.
Disclosure Statement: e authors declare no conict of interest.
744
PI3KCA somatic mutations in pramry male breast cancer
Sabine Lubig1; Lara Hoppenrath1; Melanie Erices-Leclercq1;
StephanBaldus2; Robert Förster3; Frank Förster4; Christian Rudlowski1;
Thomas Barthel5
1Frauenklinik, Evangelisches Krankenhaus Bergisch Gladbach, Bergisch
Gladbach, Deutschland
2Institut für Pathologie und Zytopathologie, Bergisch Gladbach, Deutschland
3Institute for Radiation Oncology, Cantonal Hospital Winterthur, Winterthur,
Schweiz
4Department of Economical Sciences, University of Applied Sciences, Zwickau,
and Outpatient Department of Gynecological Oncology and Palliative Care,
Poliklinik GmbH, Chemnitz, Deutschland
5Novartis Pharma GmbH, Nürnberg, Deutschland
Background: Breast cancer patients with PI3KCA somatic mutations ben-
et from treatment with PI3K inhibitors. Studies are lacking to identify
PI3KCA mutations in male breast cancer (MBC) patients. e evidence
of PIK3CA mutations in MBC could oer new treatment options for this
distinctive subgroup. In this study we evaluate frequency and spectrum of
PIK3CA mutations in primary male MBC.
Methods: Paran-embedded tumor samples from 131 male patients
who were diagnosed and treated for primary invasive breast cancer from
1995 to 2022 at Breast Cancer Units in Bergisch Gladbach, Chemnitz
and Zwickau, Germany were collected. Proportion and distribution of
PI3KCA mutations were assessed by next-generation sequencing (NGS).
Results were statistically correlated with patient characteristics and
follow-up data.
Result: At present 87 out of 131 cases were evaluated. 23 tumors (26.4%)
showed PIK3CA mutations. 11 patients had a H1047R mutation, 5 patients
a E656K, two patients a H1057L mutation and one patient each showed
a E103_P104del, C420R, E453K, E542K and H855Y mutation. Frequency
and spectrum of PIK3CA mutations did not correlate with tumor charac-
teristics and patients survival.
Discussion: is is the rst comprehensive study that evaluates PIK3CA
mutations by NGS in primary MBC. e results demonstrate that more than
25% of the MBC patients could benet from a PIK3CA targeted therapy.
Studies with larger cohorts of MBC patients are needed to determine the
prognostic value of frequency and spectrum of PIK3CA mutations in MBC.
Conclusion: A signicant part of primary MBC shows PIK3CA muta-
tions and are suitable for PIK3CA targeted therapy.
Disclosure Statement: e authors declare the following: e authors declare that
they received research funding from Novartis AG to evaluate PIK3CA mutations
in this study.
760
Development of a decision support system to reduce the time
burden of interdisciplinary tumor conferences, using the
example of a Certied Breast Cancer
Thomas Elter1,2,3; Paulina Klose4; Laura Hamacher1; David Hoier2,5;
MichaelHallek1; Carolin Groß-Opho-Müller2,6; Andreas Greeske2;
JonasHeidelbach2; Cristin Kuehn7; Wolfram Malter4
1University of Cologne, Department I of Internal Medicine, Center for Integrated
Oncology Aachen Bonn Cologne Duesseldorf, Cologne, Deutschland
2Onqo Health GmbH, Cologne, Deutschland
3University of Cologne, Department I of Internal Medicine, Center for Integrated
Oncology Aachen Bonn Cologne Duesseldorf, Cologne, Deutschland
4University of Cologne, Breast Cancer Center, Center for Integrated Oncology
Aachen Bonn Cologne Duesseldorf, Cologne, Deutschland
5St. Martinus Krankenhaus, Duesseldorf, Deutschland
6Kliniken der Stadt Köln gGmbH, Köln, Deutschland
7Brustzentrum Unna-Lünen, Lünen
Background: We developed a decision support system (DSS) for breast
cancer multidisciplinary tumor boards (MTB) that provides treatment
recommendations for predened standard cases when the cases are regis-
tered for presentation at MTB.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 39
Methods: We created a query algorithm that simulated a MTB registra-
tion and requested all necessary information to provide treatment rec-
ommendations. is algorithm was then implemented in the oncology
smartphone application “EasyOncology” to easily match and analyze DSS
and MTB decisions. e evaluation included 348 stage I-IIB (M0) and
1036 stage IV (M1) breast cancer cases discussed at the M0 and M1 MTBs
of the University Hospital Cologne from 2018 to 2022.
Result: Of those cases with complete board documentation, 222 cases
fullled pre-selection criteria for assumed “standard cases, most of them
localized breast cancer cases (n=151) and only 71 M1-cases. First analysis
showed a concordance rate for DSS and MTB decisions of 91.4% (n=138)
in the M0 cohort and 71% (n=17) in the M1 cohort. ose factors that
were not suitable for preselection of standard cases were identied and the
query was adapted accordingly (e.g. luminal B subtype in M0 or hormone
receptor switch in relapsed M1). e results of the second analysis with
adjusted query will be presented.
Discussion: It must be underlined that the goal of our work is not to
replace medical expertise. Instead, our premise is to ease MTBs time
burden by providing recommendations for “simple” cases which are
identied by reliable criteria. ese standard cases would be documented
accordingly in the MTB protocol and could only be discussed optionally.
Conclusion: Besides reduction of documentation burden and quality
assurance, our automated approach would allow more time for the discus-
sion of the complex tumor cases.
Disclosure Statement: e authors declare the following: omas Elter is founder
and CEO of Onqo Health GmbH Carolin Groß-Opho-Müller is a research
assistant at Onqo Health GmbH David Hoier is a research associate at Onqo
Health GmbH, Jonas Heidelbach is CMO and Andreas Greeske the CTO
of Onqo Health.
762
Phase 3 study of tucatinib or placebo in combination with
trastuzumab and pertuzumab as maintenance therapy for
HER2+ metastatic breast cancer (HER2CLIMB-05, trial in
progress)
Verena Kiver1; Erika Hamilton2; Junji Tsurutani3; Giuseppe Curigliano4;
Miguel Martín5; Ciara O’sullivan6; Joo Hyuk Sohn7; Konstantinos
Tryfonidis8; Libero Santarpia9; Shan Yang9; Véronique Diéras10
1Charité – Universitätsmedizin Berlin, Berlin, Deutschland
2Sarah Cannon Research Institute, Nashville, TN, USA
3Advanced Cancer Translational Research Institute at Showa University,
Tokyo,Japan
4European Institute of Oncology, IRCCS, University of Milano, Milan, Italien
5Hospital General Universitario Gregorio Marañón, Madrid, Spanien
6Mayo Clinic, Rochester, MN, USA
7Yonsei Cancer Center, Seoul, Republik Korea
8Merck & Co Inc, Rahway, NJ, USA
9Seagen Inc., Bothell, WA, USA
10Eugene Marquis Center, Rennes, Frankreich
Background: e current rst-line (1L) standard of care (SOC) for human
epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer
(MBC) is trastuzumab (T) plus pertuzumab (P) and a taxane; most patients
(pts) progress during maintenance therapy with T+P. Tucatinib is a tyrosine
kinase inhibitor (TKI) approved in combination with T and capecitabine for
HER2+ MBC with and without brain metastases (BM). In HER2CLIMB, the
addition of tucatinib signicantly improved outcomes in pts with HER2+
MBC, was well tolerated, and reduced the risk of disease progression or
death in pts with untreated and/or active BM. HER2CLIMB-05 investigates
whether adding tucatinib to 1L SOC as maintenance therapy will extend pro-
gression-free survival (PFS) while maintaining quality of life (QOL).
Methods: HER2CLIMB-05 (NCT05132582) is a phase 3, randomized,
double-blind study evaluating tucatinib plus T+P as maintenance ther-
apy for HER2+ MBC. Approximately 650 pts will be enrolled. Eligible
pts will have advanced HER2+ disease, no progression on 4-8 cycles of
prior 1L SOC, Eastern Cooperative Oncology Group Performance Status
of 0 or 1, and no or asymptomatic BM. Exclusion criteria include prior
treatment with anti-HER2 and/or anti-epidermal growth factor receptor
TKI (priorSOC for early BC is permitted) or inability to undergo contrast
magnetic resonance imaging of the brain.
Pts will be randomized 1:1 to receive either tucatinib or placebo twice
daily, with T+P once every 21 days. Pts with hormone receptor-positive
disease may receive endocrine therapy. e primary endpoint is inves-
tigator-assessed PFS. Secondary endpoints include overall survival (OS),
time to deterioration of health-related QOL, central nervous system PFS,
safety, and pharmacokinetic parameters.
Enrollment is ongoing in Germany, Belgium, Switzerland, Austria, France,
Spain, Portugal, Italy, Greece, the UK and the US, and several Asia-Pacic
and Latin America countries.
is abstract was previously presented at ESMO-BC 2022, Final Publication
Number: 415, by Véronique Diéras (reused with permission).
Disclosure Statement: e authors declare no conict of interest.
810
A prospective, randomized superiority trial for liquid-biopsy
based early breast cancer follow-up – the SURVIVE-Study
Sophia Huesmann1; Franziska Mergel1; Kerstin Pster1; Angelina Fink1;
Forca Mehmeti1; Henning Schäer1; Tanja Fehm2; Volkmar Müller3;
KlausPantel4; Thomas W. P. Friedl1; Lisa Wiesmüller1; Andreas Hartkopf5;
Ramona Erber6; Arndt Hartmann6; Matthias Beckmann7; Peter Andreas
Fasching7; Brigitte Rack1; Wolfgang Janni1
1Klinik für Frauenheilkunde und Geburtshilfe (Frauenklinik) -
Universitätsklinikum Ulm, Ulm, Deutschland
2Universitätsklinikum Düsseldorf Klinik für Frauenheilkunde und Geburtshilfe
Notaufnahme, Düsseldorf, Deutschland
3Universitätsklinikum Hamburg-Eppendorf Klinik und Poliklinik für Gynäkologie,
Hamburg, Deutschland
4Universitätsklinikum Hamburg-Eppendorf Center for experimental medicine,
Hamburg, Deutschland
5Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
6Universitätsklinikum Erlangen Pathologisches Institut, Erlangen, Deutschland
7Universitätsklinikum Erlangen Frauenklinik, Erlangen, Deutschland
Background: Due to data published in the 1990s lacking the evidence of
superiority in screening for distant metastases, imaging in early breast
cancer (EBC) follow-up is limited to detecting local recurrence. Modern
studies investigating EBC follow-up and an impact of earlier detection of
distant metastases are missing entirely.
Methods: e SURVIVE study is a prospective, 1:1 randomized, con-
trolled, partly-blinded trial, including 3500 medium to high-risk EBC
patients aer completion of primary antitumor therapy. Participants
are randomized to either Standard or liquid-biopsy based Intensive
Surveillance. Blood sampling at 150 study centers in Germany will occur
in guideline-based intervals for EBC follow-up (three monthly year 1-3,
6 monthly years 4-5 aer completion of primary therapy). While the
Standard Surveillance samples will be stored in a biobank for translational
studies, the samples of the Intensive Surveillance arm will be analyzed for
tumor markers (CA27.29, CEA, CA125), circulating tumor cells (CTC)
and circulating tumor-DNA (ctDNA). Indicative of minimal residual
disease, imaging will be triggered if any of these markers show a pre-
specied abnormal result. If secondary disease is detected, patients will
receive standard of care for metastatic disease. If imaging shows no signs
for metastases, patients will continue liquid-biopsy testing and may get
the chance to participate in therapy-intervention studies at the stage of
molecular relapse. e Co-primary endpoints of this study are overall sur-
vival and the detected lead-time in the Intensive Surveillance arm (earlier
detection of metastasis compared to Standard Surveillance).
Result: n/a.
Conclusion: e SURVIVE-study aims to question 30-year-old data and
its relevance in times of modern diagnostics and therapeutic regimes.
is study not only opens up the possibility for patients to participate in
therapy-intervention studies at the stage of molecular-relapse, but may, if
positive, lead to a paradigm shi in EBC follow-up.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts40
837
Impact of TMEM16F (ANO6) activity on fusion of human
mammary epithelial cells and human breast cancer cells
Leonie Huwa; Maja Kneissig; Thomas Dittmar
Chair of Immunology, Center for Biomedical Education and Research (ZBAF),
University of Witten/Herdecke, Witten, Deutschland
Background: Cell fusion is mandatory for physiological processes,
such as placentation and myogenesis, and pathophysiological processes,
including cancer. It has been demonstrated that the phospholipid phos-
phatidylserine (PS) plays a crucial role in cell merger. Translocation of PS
from the inner to the outer leaet of the plasma membrane is facilitated
by scramblases, such as TMEM16F (ANO6). Inhibition of scramblase
activity was correlated with reduced PS externalization and diminished
syncytia formation. Here, the impact of TMEM16F (ANO6) activity on
the fusion of human mammary epithelial cells and human breast cancer
cells was investigated.
Methods: TMEM16E,-F,-G expression in human mammary epithe-
lial cells (M13SV1-Syn1-DSP8-11) and human breast cancer cells
(HS-578-T-DSP1-7; MDA-MB-231-DSP1-7) was determined by qPCR.
TMEM16F (ANO6) activity was blocked using dierent concentrations of
Niclosamid, Hexachlorophen, Salinomycin and Clofazimin and CRISPR/
Cas9 knockout. Fusion-frequency (DSP1-7 + DSP8-11 = GFP) of the cells
was determined by FACS. Additionally, the impact of the inhibitors on cell
proliferation and colony formation was analyzed.
Results: TMEM16F (ANO6) expression is only expressed in breast cancer
cells. Used drugs led to increased fusion rates and most of them reduced
the colony formation potential without having an impact on cell prolifera-
tion. Successful TMEM16F (ANO6) CRISPR/Cas9 knockout in HS578T-
DSP1-7-cells was validated by sequencing.
Discussion: Used drugs seem to activate cell fusion, which is in contrast
to the hypothesis that TMEM16F (ANO6) inhibition impairs cell merger.
No toxic eects of the used drugs were observed. How exactly the used
drugs trigger cell fusion remains unknown.
Conclusion: In summary, the study shows that TMEM16F (ANO6) is
likely not involved in the fusion of breast cancer cells and human mam-
mary epithelial cells. Nonetheless, further studies are recommended to
investigate the impact of scramblase activity and PS on cancer cell fusion.
Disclosure Statement: e authors declare no conict of interest.
841
Impact of microplastic on mammary epithelial cells,
breast-cancer-cells and cell fusion
Maximilian Schnee1; Thomas Dittmar2
1Chair of Immunology, Center for Biomedical Education and Research (ZBAF),
University of Witten/Herdecke, Witten, Deutschland
2Chair of Immunology, Center for Biomedical Education and Research (ZBAF),
University of Witten/Herdecke, Witten, Deutschland
Background: Plastic pollution of the environment is becoming a tre-
mendous problem of recent times. Only a few eects on human health
have been researched so far. e aim of the study was to investigate the
inuence of microplastics (MPs) on human mammary epithelial cells and
human breast cancer cells.
Methods: Human mammary epithelial cells (M13SV1-Syn1-DSP8-11)
and breast cancer cells (HS-578-T-DSP1-7 and MDA-MB-231-DSP1-7)
were co-cultivated with green uorescent polystyrene (PS) microbeads for
up to 72h. e PS-microbeads were used in three dierent granulometries
(0.5µm, 1.0µm, 4.5µm). Particle absorption and the cell fusion rate were
measured by FACS (DSP1-7 + DSP8-11 = GFP). Cell proliferation and
Scratch/wound healing assay was quantied using the Incucyte® SX5 sys-
tem. Colony formation capacity was analyzed by crystal violet staining.
Results: Regarding all three cell lines a dose and particle size dependent
uptake was detected. e dierent particle granulometries had no signif-
icant eects on the fusion rates and the colony formation capacities of
the cells. In contrast, cell proliferation studies demonstrated that in the
MDA-MB-231 cells, the 1.0µm and in the M13SV1-Syn1 cells the 0.5µm
PS-particles resulted in increased proliferation rates. However, cell migra-
tion was accelerated by MPs.
Discussion: One suspected reason why in this study some investigated
cell mechanisms remained unaected could be the relatively short expo-
sure of the cells to the MPs. Aer all, cancer does not manifest itself over
a few days, and so it is not surprising that exposure to microplastics can
have eects on cells and potential malignancy only aer a longer period
of time.
Conclusion: In summary, MPs were uptaken in a dose and particle size
dependent manner by human breast cancer cells and mammary epithe-
lial cells and have an impact on cell proliferation and migration. Whether
microplastic in general might be a risk factor for breast cancer progression
needs to be evaluated in further studies.
Disclosure Statement: e authors declare no conict of interest.
845
Inuence of NEDD9 in TNBC breast cancer stem cells
Thomas Hansen; Saskia Breuel; Elmar Stickeler; Jochen Maurer
Uniklinik Aachen, Aachen, Deutschland
Background: During breast cancer treatment, therapy resistance and
metastatic dissemination are the main problems that have to be faced.
Breast cancer stem cells (BCSC) have been suggested to be responsible
for both therapy resistance and metastatic dissemination. e scaolding
protein NEDD9 regulated by cell attachment, growth factors and chemok-
ine signaling is linked to migration, proliferation and survival pathways.
High expression of NEDD9 promote metastasis and drug resistance and
correlate with a poor prognosis in several cancers including TNBC.
Methods: BCSCs were transduced via virus to either overexpress NEDD9
or knockout NEDD9 depending on the protein expression of NEDD9 in
wild type cells. Aerwards functional assays (proliferation, scratch/inva-
sion, CFU) and quantitative assays were performed to analyze the eects.
Finally selected cell lines were transplanted in mice.
Result: We found that NEDD9 overexpression leads to an increased
migration in BCSCs. Furthermore the CFU showed that despite the
amount of spheres was equal the size of NEDD9 overexpressing spheres
was signicantly smaller. e same was found for tumor size in an animal
experiment.
Discussion: We show that NEDD9 overexpression can reduce tumor
growth although most literature deviate from this. One hint is a shi in
the stem cell population. e exact mechanism needs to be claried.
Conclusion: Taken together NEDD9 showed a promising potential in
BCSCs which needs to be further examined.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 41
931
Feasibility of targeted therapies in the adjuvant setting
of early breast cancer in men -real-world data from a
population-based registry
Marie Louise Frevert1; Dominik Dannehl2; Lina Jansen3; Silke Hermann3;
Henning Schäer4; Sarah Huwer1; Ingolf Juhasz-Böss1;
Andreas Hartkopf2; Florin-Andrei Taran1
1Department of Obstetrics and Gynecology, University Medical Center Freiburg,
Faculty of Medicine, University of Freiburg, Freiburg, Deutschland
2Department of Womens Health, Tuebingen University Hospital, Tuebingen,
Deutschland
3Epidemiological Cancer Registry Baden-Württemberg, German Cancer
Research Center (DKFZ), Heidelberg, Deutschland
4Department of Obstetrics and Gynecology, University Clinic Ulm, Faculty
of Medicine, University of Ulm, Ulm, Deutschland
Background: Abemaciclib and ribociclib in combination with endocrine
therapy improve iDFS in patients with HR+/HER2- early breast can-
cer (eBC) at high risk of recurrence. Olaparib improves both iDFS and
OS when given to HER2- eBC patients harboring a BRCA1 or BRCA2
germline mutation. In the MonarchE, NATALEE and OlympiA trials, only
few male patients were included (0.4%, 0.6% and 0.3%, respectively). e
objective of this real-world analysis was to determine the number of men
with eBC meeting the inclusion criteria of these trials.
Methods: We conducted a data inquiry and analysis with the Cancer
Registry of Baden-Württemberg of men with breast cancer diagnosed
between January 1, 2015 and December 31, 2021. Men with eBC were
identied and screened according to the inclusion criteria of the three
above-mentioned trials.
Result: Of 397 men with eBC, 354 (89.1%) had a HR+/Her2- and 4 (1%)
a triple-negative subtype. Of the former, 84 patients (23.7%) fullled the
monarchE and 189 (53.3%) the NATALEE inclusion criteria. Of 358 Her2-
eBC patients, 50 (13.9%) were at clinical high risk according to OlympiA
(2 with TNBC, 48 with HR+/HER2- eBC).
Discussion: In a large real-world sample, more men fulll the inclusion
criteria of monarchE, NATALEE and OlympiA than would be expected in
women. is was due to more advanced stages at diagnosis in men.
Conclusion: Approximately 1 in 4 men with eBC would meet the inclu-
sion criteria of MonarchE, half the patients those for NATALEE and 1 in 7
the high-risk criteria of OlympiA. To observe whether CDK4/6 inhibitors
and PARPi improve prognosis also in men must be the topic of future
(real world) analyses. As we could show, eligible patients exist for these
treatment options.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
956
Immunhistochemical analysis of RUNX3 expression in breast
cancer and RUNX3 characterization in TNBC cell lines
Annika Wendt; Luise Kroll; Olivia Komor; Fabian Munzert; DavitBokhua;
Ingo B. Runnebaum; Norman Haefner
Jena University Hospital, Dept. of Gynecology, Jena, Deutschland
Background: e transcription factor RUNX3 is involved in cell prolif-
eration and dierentiation. e function in breast cancer and its contri-
bution to carcinogenic phenotypes and the disease outcome is not well
described. us, we aimed to analyze the protein expression of RUNX3
in clinical samples and analyzed the phenotypic consequences of gene
expression modulation in TNBC cell lines.
Methods: Immunhistochemical staining for n=87 breast cancer cases
was conducted with the DAKO Real Envision HRP system using anti-
bodies against ERa, ERb, PR, Her2, Ki67 und RUNX3. TNBC cell lines
(HCC1806 – RUNX3+ and MDA-MB-231 – RUNX3-) were transduced
to overexpress (MDA-MB-231) or silence RUNX3 (HCC1806). Cells were
analyzed for cell death and cell cycle distribution (FACS), colony forma-
tion capacity, and cisplatin sensitivity (MTT assay, FACS).
Result: RUNX3 protein expression in tumor cells was detected in the
minority of cases (n=16, 18.4%). However, nearly half of the basal breast
cancer cases expressed RUNX3 (n=13 of 29 cases, 44.8%). us, RUNX3-
positive breast cancers showed signicantly lower ERa, PR and Her2
expression but higher proliferation rate (Ki67). In-vitro characterization
revealed reduced colony formation in both model systems, cell cycle shi
from G2/M to G1/S or vice versa and increased or reduced sensitivity for
Cisplatin aer modulation of RUNX3 gene expression in HCC1806 or
MDA-MB-231, respectively.
Discussion: RUNX3 expressing tumors are enriched in the basal/TNBC
subtype. e colony formation ability of TNBC cell lines with or with-
out RUNX3 expression seems to be adapted to the specic RUNX3
state. However, Cisplatin resistance is potentially mediated by RUNX3
expression.
Conclusion: ese data has to be validated in other TNBC cell lines and
the clinical relevance for basal breast cancer has to be determined.
Disclosure Statement: e authors declare no conict of interest.
Central Nervous System
123
Glycation Leads to Increased Invasion of Glioblastoma Cells
Paola Schildhauer; Christian Scheller; Christian Strauss; Sandra Leisz;
Maximilian Scheer
Universitätsklinikum Halle (Saale), Klinik für Neurochirurgie, Universitätsmedizin
Halle, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
Background: Glioblastoma (GBM) is a highly aggressive and invasive
brain tumour with poor prognosis despite extensive treatment. A conse-
quence of the glycolytic switch to aerobic glycolysis (Warburg eect) in
these cancer cells, is the increased production of methylglyoxal (MGO) a
potent glycation agent with pro-tumorigenic characteristics. In this study,
we investigated the impact of MGO on GBM and glioma cell invasion and
the ECM proteins involved in these mechanisms.
Methods: We analysed the eect of dierent MGO concentration (0-1
mmol/l) on the cell lines U251, LN229, U343 and human astrocytes (hA).
Cell viability was examined with XTT assays and microscopy. Invasion,
adhesion and chemotactic cell migration were measured with the Real
Time Cell Analyzer (xCelligence). Furthermore, ECM proteins were
examined on mRNA level using qPCR and E- and N-cadherin on protein
level using immunoblotting.
Result: Increasing concentrations of MGO led the accumulation of
advanced glycation end-products and decreased cell viability. e inva-
siveness of the GBM cell lines increased under the inuence of physiolog-
ical MGO concentrations (0.3 mmol/l), whereas the invasive potential of
hA decreased. In addition, glycation had dierential eects on ECM com-
ponents that are involved in the invasion progress, upregulating TGFβ,
brevican and tenascin C in the GBM cell lines LN229 and U251.
Discussion: We could demonstrate that glycation with MGO leads to
increased invasion of glioma and GBM cells, resulting in more aggressive
cell types. In addition, we could show the glycation has cell line specic
eects on ECM expression. Both brevican and tensacin C, which were
foung upregulated in the GBM cell lines aer glycation are commomly
know to aid invasion.
Conclusion: Glycation leads to a more aggressive behavior of glioma
cells. Further studies are necessary to examine the prevention of glyca-
tion as new potential therapeutic strategies such as MGO-scavengers and
Glyoxalase1-activators against glioma and GBM.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts42
124
Glycation interferes with Sialyltransferase Expression of
Glioblastoma Cell Lines and leads to increased Polysialylation
Paola Schildhauer; Christian Scheller; Christian Strauss; Sandra Leisz;
Maximilian Scheer
Universitätsklinikum Halle (Saale), Klinik für Neurochirurgie, Universitätsmedizin
Halle, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
Background: As known for other tumours, Glioblastoma (GBM) cells pre-
fer aerobic glycolysis for energy production (Warburg eect). is results
in an increase of the reactive by-product Methylglyoxal (MGO), which
leads to irreversible glycation resulting in protein functions’ alterations.
Previous studies have shown that glycation aects polysialylation, another
common characteristic of cancer cells. Polysialylation, which results from
upregulation of sialyltransferases modulates cell-cell-adhesion, invasion
and immune recognition, is marked as a hallmark of cancer.
Methods: e cell lines U251, LN229, U343 and human astrocytes (hA)
were treated with MGO and subsequently sialyltransferase expression was
analysed using qPCR. Polysialylation was examined with immunoblot-
ting. In addition, RNAseq analysis of eight patient primary cultures from
tumours with dierent glioma grades were evaluated on the sialyltrans-
ferase expression prole
Result: e glioma cell lines and primary cultures showed a dierential
gene expression pattern of sialyltransferases. Glycation led to upregula-
tion of all sialyltransferases in the LN229 cell line and ST8SIA4 in the
U251. In contrast, MGO did not aect the sialyltransferase expression
or lead to downregulation in the remaining cell lines. Polysialylation was
detected in the cell lines expressing the corresponding sialyltransferases
and was increased aer glycation in the LN229 and U251.
Discussion: Expression of sialyltransferases showed dierential gene
expression between the cell lines and patient primary cultures, which
could be due to dierent glioma subtypes and genetic background.
Glycation showed cell line specic eects on the expression of sialyltrans-
ferases. Polysialylation was increased aer glycation.
Conclusion: Polysialylation could result in a more aggressive phenotype,
due to the involvement in cancer hallmark processes such as immune eva-
sion, resistance to apoptosis and enhancing invasion.
Disclosure Statement: e authors declare no conict of interest.
125
Synergistic Eects of Combining Tumor Treating Fields with
Nimodipine in Glioma Cells
Konstantin Hauschild; Christian Scheller; Christian Strauss; Sandra Leisz;
Maximilian Scheer
Universitätsklinikum Halle (Saale), Klinik für Neurochirurgie, Universitätsmedizin
Halle, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
Background: e application of alternating electric elds (TTFields) to
glioblastomas was able to prolong progression-free and overall survival.
Calcium channel activation appears to be a mechanism of action of
TTFields. Nimodipine as a calcium antagonist has so far found its indica-
tion in neurosurgery in the prophylaxis of vasospasm aer subarachnoid
hemorrhage. Our own preliminary work showed a cell type independent
neuroprotective and -regenerative eect in neuronal cells and increased
therapy response of cancer cells. Furthermore, there is evidence of
improved response of selected cell lines to TTFields in combination with
other calcium channel inhibitors.
Methods: Glioma cell lines LN299 (grade 4) and U343 (grade 3) were
used. 5×104 cells pre-treated with 20µmol/l nimodipine were exposed to
TTFields for 24 and 48h using the Inovitro™ system while maintaining the
drug therapy. Subsequently, cell death was analyzed by cell counting with
the Chemotec CellCount and sulforhodamine B assay.
Result: e results showed a 29.3% reduction in cell number (LN229)
with nimodipine therapy and 15.8% with TTFields aer 24h. A combina-
tion of nimodipine and TTFields resulted in a 60.4% reduction in the trial,
For U343, a similar observation was made: -17.6% cells with nimodip-
ine and +12.1% with TTFields therapy only, and the largest reduction
with combination therapy at -27.5% (nimodipine + TTFields). Over the
48-hour period, the values with lower signicance are -2% (nimodipine),
-23.4% (TTFields), and -89% (combination therapy) for cell line LN229
and -50% (nimodipine), -88.9% (TTFields), and -95.5% (combination
therapy) for U343.
Discussion: e combination of TTFields and nimodipine administra-
tion appears to be superior to TTFields therapy alone in terms of cell
death, with not only an additive but also a synergistic eect.
Conclusion: e results indicate that therapy with TTFields and nimodip-
ine could have a positive impact on progression-free and overall survival
in WHO grade 3 and 4 tumours.
Disclosure Statement: e authors declare no conict of interest.
235
Neuroprotective radiotherapy for treatment of brain
metastases – rst results of a pattern-of-care survey in
German-speaking countries
Nils Gleim; Alexander Rühle; Nils Henrik Nicolay; Clemens Seidel
Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Leipzig, Leipzig,
Deutschland
Background: Within recent years there are increasing options for radio-
therapy (RT) of brain metastases (BM) with optimized neuroprotection.
Stereotactic radiotherapy (SRT) allows sparing of unaected regions even
for multiple BM. Hippocampal-sparing whole brain RT (HS-WBRT) pre-
serves neural stem cells and cognitive function compared to conventional
WBRT. e drug memantine (NMDA receptor antagonist) has shown
indication of improving cognitive function when used concomitant with
HS-WBRT. It is not known to which extent these approaches have become
part of general RT practice in German-speaking countries.
Methods: We performed an online survey among RT centres in
Germany, Austria and Switzerland registered within the German Society
for Radiation Oncology (Deutsche Gesellscha für Radioonkologie,
DEGRO). From April to June 2023, centres were invited to participate in
a survey including 29 questions concerning use of SRT, HS-WBRT and
memantine in RT of BM.
Results: e survey was completed by 78 centres (18.2% of all invited
centres), among them 24 university hospitals, 24 non-university hospi-
tals and 30 outpatient centres. WBRT was treatment of choice starting
from 4-5 BM, 6-10 BM and > 10 BM in 25%, 49%, 26% of centres, respec-
tively. For therapeutic WBRT, hippocampal sparing was used occasion-
ally in 48% and regularly in 26% of centres. For prophylactic WBRT in
SCLC, HS-WBRT was occasionally or regularly used in 21% and 37% of
centres, respectively. 14% of centres reported the concurrent application
of memantine to WBRT. ere were regional dierences and dierences
between dierent types of centres regarding neuroprotective techniques
in RT.
Discussion: A majority of centres uses WBRT in patients with > 5 BM,
and HS-WBRT is used commonly in many centres. In contrast, concur-
rent memantine is only rarely used for RT.
Conclusion: ere is considerable heterogeneity regarding neuropro-
tective RT approaches in patients with BM in German-speaking centres.
Further detailed analyses will be presented.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 43
291
Clinical Implications of DNA Methylation-based Integrated
Classication of Histologically dened Grade 2 Meningiomas
Felix Ehret1; Eilís Pérez2; Siyer Roohani1; David Capper2; David Kaul1
1Charité - Universitätsmedizin Berlin, Department of Radiation Oncology, Berlin,
Deutschland
2Charité - Universitätsmedizin Berlin, Department of Neuropathology, Berlin,
Deutschland
Background: e integration of DNA-methylation analysis with histo-
pathological characteristics and genetic markers enables a more precise
risk stratication and classication of meningiomas. However, the impli-
cations of such a classication for patients suering from grade 2 menin-
giomas, a particular heterogeneous tumor entity, are poorly understood.
We correlate the outcomes of histopathologically conrmed grade 2 men-
ingioma with an integrated molecular-morphologic risk stratication and
determine its clinical implications.
Methods: Grade 2 meningioma patients treated at our institution were
re-classied using an integrated risk stratication and underwent DNA-
methylation and TERT promoter mutation analyses.
Result: Grade 2 meningiomas treated between 2007 and 2021 (n = 123)
were retrospectively analyzed. e median clinical and radiographic fol-
low-up periods were 56.3 and 51.4 months. e distribution of the inte-
grated molecular-morphologic risk groups was as follows: 43 benign
(35%), 62 intermediate (50%), and 18 high-risk (15%). In the multivar-
iable Cox regression analysis, integrated risk groups were signicantly
associated with the risk of local recurrence (hazard ratio (HR) interme-
diate: 5.8, HR high-risk: 6.0, both p < 0.01; vs. low), while resection status
was not (HR gross total resection: 0.46, p = 0.07; vs. subtotal resection).
Only one TERT promoter mutation and one homozygous deletion of
CDKN2A/B were identied.
Discussion: Only around 50% of grade 2 meningiomas have an interme-
diated risk prole. erefore, histopathological assessment alone is not
sucient to adequately assess the biological behavior of meningiomas.
Prospective use of molecular-morphological classiers will be essential
to determine the ecacy of treatments in homogeneous tumor cohorts.
Conclusion: Integrated molecular risk stratication is crucial to guide the
clinical management and counseling of patients with grade 2 meningi-
omas and should be routinely applied to avoid over- and undertreatment.
Disclosure Statement: e authors declare no conict of interest.
349
Characterization of the circadian clock of glioblastoma cell
lines and primary glioblastoma cells: exploring the way to
personalized circadian medicine in glioblastoma
Nina Nelson1; Oliver Heese2; Angela Relógio1
1Institute for Systems Medicine and Faculty of Human Medicine, MSH Medical
School Hamburg, Hamburg, Deutschland
2Department of Neurosurgery and Spinal Surgery, HELIOS Medical Center
Schwerin, University Campus of MSH Medical School Hamburg, Hamburg,
Deutschland
Background: Glioblastoma (GBM) is one of the most lethal tumors types.
Despite eorts to improve GBM therapy success is limited. is calls for
novel innovative therapy concepts. Chronotherapy accounts for the cir-
cadian rhythm of patients and while promising results were reported in
pre-clinical GBM models, clinical studies are contradictory likely due to
neglection of individual clock proles [1].
Methods: Here we characterize the circadian rhythm of GBM cell lines
and primary GBM cells on a cellular, RNA- and protein level and inves-
tigate the eects of clock manipulation via KO or pharmacological inter-
ventions, also at the functional level by measuring proliferation and
cytotoxicity in a Life-Cell Imaging System. Further, we determine the
optimal treatment timepoint of Temozolomide (TMZ) in our system.
Result: We characterized the circadian rhythm of 3 GBM cell lines and
our data showed that pharmacological manipulation of the clock impacted
circadian parameters. ese results will be further investigated using
primary GBM cells, which will allow us to study the circadian rhythm
in a patient-mimicking system. We will use our previously established
time-dependent treatment protocols [2] to establish optimized TMZ-
Chronotherapy regimes in our GBM system.
Discussion: e integration of our experimental data in personalized
mathematical models will allow us to predict optimal treatment times for
GBM.
Conclusion: Personalized circadian medicine has enormous potential in
GBM. Interlocking experimental data with mathematical modelling pro-
vides a way to establish non-invasive measurement of clock parameters as
companion diagnosis for personalized chronotherapy in the future.
References:
1 Petković M, Henis M, Heese O, Relógio A: Chronotherapy in glioblastoma:
State of the art and future perspectives. eBioMedicine (2023) 89.
2 Basti A, Malhan D, Dumbani M, Dahlmann M, Stein U, Relogio A: Core-clock
genes regulate proliferation and invasion via a reciprocal interplay with macc1
in colorectal cancer cells. Cancers (Basel) (2022) 14(14).
Disclosure Statement: e authors declare no conict of interest.
376
Patient-Derived Glioblastoma Explants as a Model for the
Tumor Immune Microenvironment
Zoe Shaked1; Camila Fernández-Zapata2; David Wasilewski1;
Wenbo Sun2; Philip Bischo3; David Horst3; Julia Sophie Onken1;
Mohammad Fardin Gholami4; Thomas Picht1; Chotima Böttcher2;
Peter Vajkoczy1; Ran Xu1
1Department of Neurosurgery, Charité - Universitaetsmedizin Berlin, Berlin,
Deutschland
2Experimental and Clinical Research Center, Charité – Universitaetsmedizin
Berlin, and Berlin Institute of Health and Max Delbrück Center for Molecular
Medicine in the Helmholtz Association, Berlin, Deutschland
3Institute of Pathology, Charité - Universitaetsmedizin Berlin, Berlin,
Deutschland
4Institute of Physics, Humboldt-Universitaet zu Berlin, Berlin, Deutschland
Background: Despite the success of immune checkpoint inhibitors in var-
ious malignancies and promising preclinical results, clinical trials have not
shown a signicant survival benet in glioblastoma (GBM) to date. One
possible reason for this translational failure are the in vitro and in vivo
models used for drug testing, which fail to recapitulate GBMs complex
biology. Here, we assessed how patient-derived explants (PDEs) preserve
the tumor immune microenvironment (TiME) to evaluate whether they
could serve as a suitable model for bridging the gap between the current
preclinical models and early clinical trials.
Methods: We generated PDEs from six GBM tumors and temporal lobe
tissue of two epilepsy patients and cultured them in an air-liquid-inter-
face setup. e tumor and immune compartments were characterized at
baseline and aer four days of ex vivo culture. Tissue quality was assessed
using H&E staining and apoptosis was tested using TUNEL assay. e
tissue composition and immune landscape were analyzed using immuno-
histochemistry (IHC) and imaging mass cytometry (IMC).
Results: No signicant changes to tissue quality or excessive apoptosis
were observed. Based on the marker expression quantied by IHC and
IMC, the dierent components of the TiME, including extracellular
matrix, immune cells, inammatory and tumor proteins were preserved.
Using IMC, we also identied various host cell populations present in the
TiME and their spatial relationship and demonstrated that the TiME’s
complexity remains intact.
Discussion: Ex vivo cultures of PDEs in GBM are feasible and preserve
histological and immunological characteristics of the TiME and its spa-
tial organization. Replication studies using larger sample sizes and fur-
ther studies using gene expression analyses and functional assays are
warranted.
Conclusion: To further validate the suitability of PDEs for drug testing,
we plan to evaluate the models ability to reect pharmacological manipu-
lations, for example through drug uptake studies, and ultimately establish
a pipeline for therapy response prediction.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts44
396
Impact of perioperative Dexamethasone in the context
ofneurosurgical brain metastasis resection
David Wasilewski1; Jan Bukatz1; Ricarda Peukert1; Zoe Shaked1;
Paul Poeser1; Anna-Gila Karbe1; Anna Trelinska-Finger2;
Claudius Jelgersma1; Anton Früh1; Matthias Raspe3; Helena Radbruch4;
David Capper4; Max Schlaak5; Peter Thuss-Patience6; Philip Bischo7;
David Horst7; Marcel Krentzke8; Ran Xu1; Felix Ehret9; David Kaul9;
Martin Misch1; Lars Bullinger6; Nikolaj Frost10; Peter Vajkoczy1;
Julia Sophie Onken1
1Charité Universitaetsmedizin Berlin - Department of Neurosurgery, Berlin,
Deutschland
2Comprehensive Cancer Center Charité, Berlin, Deutschland
3Charite - Department of Neurosurgery, Berlin, Deutschland
4Charité Universitaetsmedizin Berlin - Department of Neuropathology,
Berlin, Deutschland
5Charité Universitaetsmedizin Berlin - Department of Dermatology,
Venerology and Allergology, Berlin, Deutschland
6Charité Universitaetsmedizin Berlin - Department of Hematology,
Oncology and Cancer Immunology, Berlin, Deutschland
7Charité Universitaetsmedizin Berlin - Department of Pathology,
Berlin, Deutschland
8Charité Universitaetsmedizin Berlin - Medical Archive/Zentralarchiv,
Berlin, Deutschland
9Charité Universitaetsmedizin Berlin - Department of Radiooncology,
Berlin, Deutschland
10Charité Universitaetsmedizin Berlin - Department of Infectious Diseases and
Pulmonary Medicine, Berlin, Deutschland
Background: Patients with brain metastases that undergo brain metasta-
sis resection regularly receive perioperative dexamethasone. We sought
to evaluate the impact of cumulative perioperative dexamethasone on
survival.
Methods: Data from brain metastasis patients that underwent neurosur-
gery and associated perioperative daily dexamethasone dosage (13 days
before till 13 days aer surgery) were collected. Cut-o values for cumu-
lative perioperative dexamethasone dose (continuous predictor variable
for survival) were determined using maximally selected rank statistics
and served for later dichotomization (pre- and postoperative: < 281 mg vs
≥ 281 mg). Medical records included baseline radiological, histopatho-
logical, and treatment-related characteristics. Statistical analyses included
Kaplan-Meier, Cox proportional hazards regression for overall survival
with adjustment for potential confounders including age, gender, extrac-
ranial metastases, edema volume, brain metastasis burden, pre-treatment
status as well as adjuvant treatment.
Result: 539 patients were included. Median follow-up time was 58,97
months. Aer adjusting for potential confounders patients with higher
cumulative perioperative dexamethasone (≥281 mg) showed shorter sur-
vival (HR: 1.35 (1.02-1.79, p=0.034) as compared to patients with lower
cumulative doses (<281 mg).
Discussion: Cumulative perioperative dexamethasone is linked to
decreased survival in resected brain metastases. Strict dosage, down taper
or methods reducing corticosteroid dependency should be regularly eval-
uated in clinical practice in patients with brain metastases.
Conclusion: is large single-center study suggests that in patients under-
going brain metastasis resection dexamethasone dosage should regularly
be evaluated in terms of dosing and down tapering given potential side
eects or potential impact on outcome when administered in high doses
over several weeks perioperatively.
Disclosure Statement: e authors declare no conict of interest.
414
Impact of the COVID-19 pandemic on incidence and therapy
of high-grade gliomas
Vitaly Sokotukhin1; Michael Gerken2; Monika Klinkhammer-Schalke3;
Armin Pauer2
1Hospital Barmherzige Brueder Regensburg, Regensburg, Deutschland
2Tumorzentrum Regensburg, Institut für Qualitätssicherung und
Versorgungsforschung der Universität Regensburg, Regensburg, Deutschland
3Bayerisches Krebsregister, Regionalzentrum Regensburg, Bayerisches
Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Nürnberg,
Deutschland
Background: e COVID-19 pandemic has aected neuro-oncology ser-
vices around the world. Our objective was to determine the inuence of
the COVID-19 pandemic on the incidence, grade shi, therapy and delay
of the therapy of high-grade gliomas (HGG).
Methods: Based on data of the population-based clinical cancer registry
Regensburg, pandemic years 2020 and 2021 were compared with years
2015-2019.
Result: During the investigation period from 2015 to 2021 1008 patients
with an initial diagnosis of glioma (ICD-10 diagnosis C71) were analysed.
WHO grade 3 and 4 tumors requiring urgent treatment comprised 142
(14,1%) and 744 (73,8%) patients, respectively. e analysis of the annual
number of newly diagnosed cases from 2015 to 2021 showed no clear
dierence between the years before and during the pandemic. In March
and October 2020 a not statistically signicant decrease of new cases of
37,5% (March) and 35,5% (October) compared to the comparison months
2015-2019 was observed. e portion of WHO grade 4 tumors remained
stable over the course of the study. e number of newly diagnosed WHO
grade 4 brain tumors in 2020 (73,7%, p=0,911) and 2021 (75,3%, p=0,597)
remained comparable to the number in the study period 2015–2019
(73,2%). A monthly analysis of the number of operations on gliomas
WHO grade 3 and 4 in 2020 vs. 2015–2019 showed a signicant decrease
until the middle of the year 2020. e number of operations increased rap-
idly in July 2020. e quarterly comparison 2020 vs. 2015–2019 showed a
statistically signicant decrease in surgeries in patients with WHO grade
3 and 4 gliomas in the rst and second quarter of 2020.
Conclusion: With the exception of a decrease in the number of surgical
interventions in the rst quarter of 2020, we have not identied any sig-
nicant changes in the diagnosis and treatment of HGG during the pan-
demic, as was seen in patients with other cancers, for example colorectal
and breast cancer.
Disclosure Statement: e authors declare no conict of interest.
610
Epilepsy-associated glioblastoma MRI characteristics
andbrain regions at primary diagnosis across a large
patientcohort
Yeong Chul Yun1,2,3; Katharina Holz1,2; Sabine Wolf1,2; Freya Garhöfer1,2;
Philipp Vollmuth2; Martin Bendszus2; Sabine Heiland2; Wolfgang Wick4;
Varun Venkataramani4,5; Felix T. Kurz2,3
1Faculty of Medicine, Heidelberg University, Heidelberg, Deutschland
2Department of Neuroradiology, Heidelberg University Hospital, Heidelberg,
Deutschland
3Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg,
Deutschland
4Department of Neurology, Heidelberg University Hospital, Heidelberg,
Deutschland
5Department of Functional Neuroanatomy, Heidelberg University, Heidelberg,
Deutschland
Background: Identifying brain regions where glioblastoma (GBM) is
associated with epilepsy and characterizing brain tumor characteristics
could help recognize patients with a higher risk of seizures based on mag-
netic resonance imaging (MRI).
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 45
Methods: 642 patients (no epilepsy: 469, with epilepsy: 173) with de novo
GBM received 3 Tesla MRI, including T1-weighted (T1w) images before
and aer Gadolinium contrast administration. Contrast-enhancing
tumors (CE) were segmented semi-automatically from post-contrast
T1w images. Lesion volumes obtained from segmented masks were com-
pared using Mann-Whitney U tests. Images and masks were registered
to MNI-152-space. A voxel-wise Fisher-exact test followed by random
permutation analysis (ADIFFI) for multiple comparison correction were
performed to identify regions with higher/lower occurrence of epilep-
sy-associated tumors.
Result: e CE lesion volume associated with epilepsy was signicantly
smaller than lesions without epilepsy (5.8 ml ± 0.9 ml vs. 19.9 ml ± 0.9ml;
p<0.0001). Regions, where epilepsy-related lesions were signicantly
more frequent, could not be found with ADIFFI. However, ADIFFI clus-
ters were found in subcortical regions and in white matter (WM) around
the thalamus, where occurrence of lesions without epilepsy was higher,
suggesting a preference for grey matter (GM) in epilepsy-related lesions.
Discussion: e heterogeneous distribution of epilepsy-associated lesions
and preference of GM is in accordance with previous studies. However,
the volume of symptomatic lesions was smaller, signifying that location
and/or fraction of GM vs. WM in tumor composition may be more
important than tumor size.
Conclusion: GBM lesion located in subcortical regions are less associated
with epilepsy. In cortical regions, the association of lesions with epilepsy
was indeterminate according to ADIFFI analysis.
Disclosure Statement: e authors declare no conict of interest.
729
Gliosarcoma – Clinical outcomes and prognostic
factors – Aninternational multi-institutional analysis
Siyer Roohani1,2,3; Maximilian Mirwald1; Felix Ehret1,3;
Soleiman Fabris Roohani1; Jana Käthe Strieer4; Noelle Samira Jacob4;
Enrico Pozzo5; Alessandra Gonnelli6; Camilla Satragno7; Ilinca Popp8,9;
Johannes Steel8; Jolina Handtke1; Noa Marie Claßen1; Titus Rotermund1;
Daniel Zips1,3; Peter Vajkoczy10; Ulrich Schüller11,12,13;
Mateusz Jacek Spałek14; David Kaul1,3
1Charité − Universitätsmedizin Berlin, Klinik für Radioonkologie und
Strahlentherapie, Berlin, Deutschland
2Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin,
Deutschland
3Deutsches Konsortium für Translationale Krebsforschung (DKTK), Deutsches
Krebsforschungszentrum (DKFZ), Partnerstandort Berlin, Berlin, Deutschland,
Berlin, Deutschland
4Universitätsklinikum Hamburg-Eppendorf, Zentrum für Onkologie, II.
Medizinische Klinik und Poliklinik, Hamburg, Deutschland
5Department of Radiotherapy, Istituto Oncologico Veneto IOV-IRCCS, Padua,
Italy; Department of Medicine-DIMED, University of Padua, Padua, Italien
6Radiation Oncology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italien
7Department of Experimental Medicine (DIMES), University of Genoa, Genua,
Italien
8Universitätsklinikum Freiburg, Klinik für Strahlenheilkunde, Freiburg,
Deutschland
9Deutsches Konsortium für Translationale Krebsforschung (DKTK),
Partnerstandort Freiburg, Freiburg, Deutschland
10Charité − Universitätsmedizin Berlin, Neurochirurgische Klinik, Berlin,
Deutschland
11Universitätsklinikum Hamburg-Eppendorf, Klinik für Pädiatrische Hämatologie
und Onkologie, Hamburg, Deutschland
12Universitätsklinikum Hamburg-Eppendorf, Forschungsinstitut
Kinderkrebszentrum Hamburg, Hamburg, Deutschland
13Universitätsklinikum Hamburg-Eppendorf, Institut für Neuropathologie,
Hamburg, Deutschland
14Maria Sklodowska-Curie National Research Institute of Oncology, Department
of Radiotherapy, Warschau, Polen
Background: is study sought to describe oncological outcomes and
investigate prognostic factors for patients with gliosarcoma (GSM).
Methods: Histopathologically conrmed GSM patients who received
treatment at seven European institutions were included and retrospectively
analyzed. Overall survival (OS) and progression-free survival (PFS)
were assessed using the Kaplan-Meier estimator. Multivariable Cox
regression analysis (MVA) was performed to identify factors associated
with OS and PFS.
Results: We included 159 patients with a median follow-up time of
8.6months. e majority received surgery (94.3%), postoperative radio-
therapy (pRT, 78.6%), and temozolomide (TMZ)-based postoperative che-
motherapy (65.4%). e median OS and PFS were 12.0 and 6.1 months,
respectively. At 6-month, 1-year and 2-year, OS was 72.5%, 50.8% and
22.1%, while PFS was 51.5%, 24.8% and 8.3%. In the MVA, the following
factors were signicantly associated with OS: age (hazard ratio (HR): 1.03,
p=0.008), biopsy only vs. gross total resection (HR: 10.0, p=0.003), pRT
vs. no RT (HR: 0.34, p=0.008), postoperative TMZ-based chemotherapy
vs. no chemotherapy (HR: 0.37, p=0.002), and MGMT promoter status
non-methylated vs. methylated (HR: 2.54, p=0.003). Subtotal resection,
TP53 mutational status, and tumor size were not signicantly associated
with OS. For PFS, the following factors were signicantly associated in
the MVA: biopsy only vs. gross total resection (HR: 4.30, p=0.034), TMZ-
based chemotherapy vs. no chemotherapy (HR: 0.30, p<0.001), MGMT
promoter status non-methylated vs. methylated (HR: 2.62, p=0.001).
Subtotal resection, TP53 mutational status, and tumor size were not sig-
nicantly associated with PFS.
Discussion: e intrinsic limitations to a retrospective study design must
be considered.
Conclusion: Aggressive trimodal therapy comprising surgical excision,
pRT and TMZ-based chemotherapy remain essential for oncological out-
comes, while younger age and methylated MGMT promoter status are
associated with improved survival.
Disclosure Statement: e authors declare no conict of interest.
742
Eects of Traditional Chinese Medicine (TCM) and Western
Naturopathy on survival of patients with glioblastoma
Susanne Roth-Goldbrunner1; Marco Timmer2; Charlotte Nettekoven2;
Martin Kocher3; Roland Goldbrunner2
1Klinik für Innere Medizin 1, Centrum für Integrierte Onkologie,
Universitätsklinik Köln, Köln, Deutschland
2Klinik für allgemeine Neurochirurgie, Zentrum für Neurochirurgie,
Neuroonkologisches Tumorzentrum, Universitätsklinik Köln, Köln, Deutschland
3Klinik für Stereotaktische und Funktionelle Neurochirurgie, Zentrum für
Neurochirurgie, Neuroonkologisches Tumorzentrum, Universitätsklinik Köln,
Köln, Deutschland
Background: Glioblastomas (WHO CNS grade 4) are malignant brain
tumors with a median overall survival of 15-18 months aer standard
therapy consisting of surgical resection, radiation and chemotherapy.
erefore there is a great need for therapeutic options in addition to
standard treatment. Aim of this study is to analyze the eects of comple-
mentary TCM and Western Naturopathy on progression-free survival and
overall survival.
Methods: We compared 23 patients who were treated with TCM and
Western Naturopathy in addition to standard therapy (complementary
group) with a control group of 23 patients receiving standard therapy only
(control group) who were matched according to known risk factors like
age, tumor markers (IDH mutation status, MGMT promotor methylation),
Karnofsky Performance Status and resection status (complete, incomplete).
Result: In our preliminary results the progression-free survival of the
complementary group (21.4 ± 6.9 months) was longer than that o the
control group (10,7 ± 1,3 months), but without reaching statistical signi-
cance (p = 0,073). In contrast, the overall survival was signicantly longer
in the complementary group (31,0 ± 6,7 months) compared to the control
group (17,8 ± 1,3 months; p = 0,011).
Discussion: Explanatory power of results is limited by the retrospective
study design and the small sample size. We tried to overcome this limi-
tations by appropriate matching using a large patient data pool from our
DKG certied Neurooncology Center.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts46
Conclusion: Complementary treatment with TCM and Western
Naturopathy seems to have a strong impact on overall survival of glioblas-
toma patients. is statement has to be conrmed by a prospective study
with a larger patient cohort.
Disclosure Statement: e authors declare no conict of interest.
804
Patient experience using Tumor Treating Fields (TTFields)
therapy for glioblastoma
Eleni Batzianouli1; Ksenia Finogenova2; Healther Johnson3;
Huda Ismail Abdullah3
1Novocure GmbH, Root, Schweiz
2Novocure GmbH, Munich, Deutschland
3Novocure Ltd, New York, USA
Background: TTFields are electric elds that disrupt key cancer cell sur-
vival processes. TTFields therapy is FDA-approved and CE-marked for
the treatment of newly diagnosed and recurrent glioblastoma (GBM).
Methods: Questionnaires (independently developed and administered)
were distributed by mail and online in Germany, Austria, and Switzerland
to patients/caregivers (on patient’s behalf) using TTFields (Optune;
Novocure GmbH, device manufacturer) as therapy for GBM.
Result: Between January 1, 2022, and December 31, 2022, 545 patients/
caregivers (43%) returned surveys; 43% new starters (≤2 months), 36%
short-term users (≤6 months), and 21% long-term users (>6 months).
e sex of new starters (male: 66%) and long-term users (male: 59%), as
well as age of new starters (≥60 years: 54%) reected the expected inci-
dence of the disease population. Most respondents adapted well to the
device and were satised/very satised with TTFields therapy use (new
starters: 82%; short-term users: 68%; long-term users: 67%). Most short-
term users (79%) could integrate the therapy into their daily life in <4
weeks. Most long-term users (63%) indicated that TTFields therapy use
required changes to their daily life. Respondents reported skin irritation
and device handling. Most long-term users (74%) and short-term users
(68%) would recommend TTFields therapy to others with GBM. Most
patients rated device handling as easy (long-term users: 82%; short-term
users: 78%), with good sleep being achieved by most patients (long-term
users: 77%; short-term users: 72%). In-person guidance from ‘Device
Support Specialists’ was important to 88% and 89% of short- and long-
term users, respectively.
Discussion: is assessment helped dene unmet needs to treatment and
encourages patient support services and communication with health car-
egivers and patients.
Conclusion: Most patients receiving TTFields therapy for GBM were
highly satised with the treatment and would recommend it to others.
Longer patient experience with use of TTFields therapy seemed to miti-
gate barriers to treatment.
Disclosure Statement: e authors declare the following: All authors are
employees and hold stock in Novocure.
806
Connecting the Dots - the Role of Connexins in Glioblastoma
Communication
Hannah Strobel1; Georg Karpel-Massler2; Aurelia Peraud2;
Klaus-Michael Debatin1; Mike-Andrew Westho1
1Department of Pediatrics and Adolescent Medicine, University Medical Center
Ulm, Ulm, Deutschland
2Department of Neurosurgery, University Medical Center Ulm, Ulm,
Deutschland
Background: Tumors form complex ecological niches in which individual
cells communicate with their microenvironment. Glioblastoma (GB) cells,
for instance, form long membrane protrusions that are connected to each
other via gap junctions (GJ), which are intercellular channels composed
of connexins (Cx). ese channels allow the exchange of small molecules
and ions (Ca2+). ereby, GJs/Cxs connect GB cells to huge communicat-
ing networks that are more resistant to therapy and support tumor growth
and migration. In this study, we investigated the precise Cx composition
of brain tumors with a particular focus on GB and investigated their func-
tional role.
Methods: A panel of 28 dierent patient-derived stem cell-like brain
tumor cells (SCs) and two patient-derived non-tumor primary cells were
screened for the expression of all 21 known Cxs. By comparing our nd-
ings with publicly available RNA sequencing data and performing various
in silico analyses, we identied interesting candidates. ese were further
investigated by dierent biochemical and genetic approaches - knock-out
cells were generated and analyzed with regard to cell growth, cell death,
and their capability to form morphological networks.
Results: In the present study, we found that therapeutic modulation of
GJs strongly aects the cellular behavior of primary GB cells, conrming
that primary patient material is a suitable model. Interestingly, a con-
siderable multiplicity of Cx mRNAs are expressed. Cx26 was identied
as an interesting candidate as increased expression levels are found in
grade 4 brain tumors and correlate with signicantly shorter survival.
Further, Cx26 was mainly expressed in cells of the tumor core. While
the knock-out of Cx26 does not impact cell growth and spontaneous cell
death in SCs in vitro, it does aect their capability to form morphological
networks.
Conclusion: Primary patient material-derived cells are a suitable model
to study the role of GJs/Cxs in vitro and suggest that Cx26 is involved in
GB connectivity.
Disclosure Statement: e authors declare no conict of interest.
861
NANO scale associated with de novo Glioblastoma lesion
sizeand location
Yeong Chul Yun1,2,3; Sabine Wolf1,2; Katharina Holz1,2; Freya Garhöfer1,2;
Philipp Vollmuth2; Martin Bendszus2; Sabine Heiland2; Wolfgang Wick4;
Felix T. Kurz2,3; Varun Venkataramani4,5
1Faculty of Medicine, Heidelberg University, Heidelberg, Deutschland
2Department of Neuroradiology, Heidelberg University Hospital, Heidelberg,
Deutschland
3Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg,
Deutschland
4Department of Neurology, Heidelberg University Hospital, Heidelberg,
Deutschland
5Department of Functional Neuroanatomy, Heidelberg University,
Heidelberg, Deutschland
Background: Neurologic Assessment in Neuro-Oncology (NANO) eval-
uates neurologic decits in nine domains based on simple clinical exam-
ination. We aim to correlate clinical and radiological ndings to improve
diagnostic evaluation of glioblastoma (GBM) patients.
Methods: We evaluated 3-Tesla magnetic resonance images (MRI) with
Gadolinium contrast administration from 643 patients with de novo
GBM. Neurological decits were assessed according to the NANO scale.
Contrast-enhancing tumor (CE) was segmented semi-automatically from
post-contrast T1-weighted MRIs. Lesion volumes from patients without
any NANO-score relevant decits were compared with symptomatic
patients in at least one domain using Mann-Whitney U tests. Images were
registered to MNI-152-space. Voxel-wise Fisher-exact-test followed by
random permutation analysis (ADIFFI) for multiple comparison correc-
tion was performed to identify regions with higher occurrence of tumors
associated with the decits. ADIFFI was performed for each domain of
NANO: gait, strength, ataxia, sensation, visual elds, facial strength, lan-
guage, level of consciousness and behavior.
Result: ere was a signicant correlation between NANO and CE lesion
volume (r = 0.30, p<0.0001). e volume of CE associated without any
decits (n=157, 5.6 ml ± 1.3 ml) was signicantly smaller (p<0.0001)
than lesions with decits (n=486, 18.9 ml ± 0.9 ml). For each investigated
domain with the NANO scale, radiologically correlated brain regions
could be identied with ADIFFI.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 47
Discussion: We nd a clear association between NANO scale and GBM
lesion size and location, in line with other works using symptom lesion
mapping.
Conclusion: NANO scale may provide an estimate of GBM lesion vol-
ume. In addition, for certain domains of the NANO, neurological decits
are well associated with GBM location. ese ndings suggest further
investigations into the correlation between NANO and RANO criteria
over time and their usefulness in the clinical management of GBM.
Disclosure Statement: e authors declare no conict of interest.
867
Radiogenomic analysis of a large glioma patient cohort
Varun Venkataramani1,2; Yeong Chul Yun3,4,5; Freya Garhöfer3,4;
Sabine Wolf3,4; Katharina Holz3,4; Philipp Vollmuth4; Martin Bendszus4;
Sabine Heiland4; Wolfgang Wick2; Felix T. Kurz4,5
1Department of Functional Neuroanatomy, Heidelberg University, Heidelberg,
Deutschland
2Department of Neurology, Heidelberg University Hospital, Deutschland
3Faculty of Medicine, Heidelberg University, Heidelberg, Deutschland
4Department of Neuroradiology, Heidelberg University Hospital, Heidelberg,
Deutschland
5Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg,
Deutschland
Background: e objective of this research is to assess the correlation
between brain tumor location and genomic alterations with a voxel-wise
Fisher-exact-test followed by random permutation analysis (ADIFFI) in
glioblastoma (GBM), astrocytoma and oligodendroglioma patients.
Methods: We evaluated 3-Tesla MR images with Gadolinium contrast
administration from 643 patients with de-novo GBM and 98 patients
with low-grade glioma (59 astrocytoma, 39 oligodendroglioma). ADIFFI
with multiple comparison correction was performed to identify regions with
higher occurrence of tumors associated with both methylation groups of
GBM (RTKI: 100; RTKII: 187; mesenchymal: 183) and for comparisons
between GBM and low-grade glioma. Lastly, the occurrence between
IDH-mutated, 1p/19q-codeleted oligodendroglioma and IDH-mutated,
non 1p/19q-codeleted astrocytoma was compared using ADIFFI.
Result: ere was a signicant correlation between the occurrence of oli-
godendroglioma and astrocytoma as compared to GBM with a predom-
inance in the frontal lobe adjacent to the rostral extension of the lateral
ventricles. Further analyses with ADIFFI did not reveal any dierences
in tumor location between astrocytoma and oligodendroglioma. Lastly,
all analyzed methylation groups of GBM were not signicantly correlated
with any specic brain region.
Discussion: We have analyzed the largest radiogenomic patient cohort
consisting of GBM, astrocytoma and oligodendroglioma. Our ndings are
in line with previously analyzed smaller patient cohorts. We were not able
to nd small dierences within our GBM patient cohort and furthermore
could not reveal dierences between subtypes of low-grade glioma. is
would be in line with a preferential glioma location associated with an
IDH-mutation from other groups.
Conclusion: ese radiogenomic analyses underline the importance of
the IDH-mutation for determining tumor location and potentially point
to a cell of origin along the rostral extension of the lateral ventricles.
Disclosure Statement: e authors declare no conict of interest.
945
Intraindividual hormone receptor heterogeneity in patients
with brain metastasis from breast cancer: Gain of Her2
receptor from primary tumor to brain metastasis correlates to
worsened survival
Muriel Heimann1; Anna-Laura Pottho1; Lea L. Friker2; Valeri Borger1;
Ulrich Herrlinger3; Hartmut Vatter1; Klaus Kuchelmeister2; Patrick Schuss1,4;
Matthias Schneider1
1Department of Neurosurgery, Rheinische Friedrich-Wilhelms-University
Hospital, Bonn, Deutschland
2Department of Neuropathology, Rheinische Friedrich-Wilhelms-University
Hospital, Bonn, Deutschland
3Division of Clinical Neurooncology, Department of Neurology, Rheinische
Friedrich-Wilhelms-University Hospital, Bonn, Deutschland
4Department of Neurosurgery, BG Klinikum Unfallkrankenhaus Berlin, Berlin,
Deutschland
Background: Deciphering the dynamics of intraindividual tumor het-
erogeneity is supposed to more precisely predict long-term outcome in
patients with advanced stages of cancer. In patients with brain metasta-
sis (BM) from breast cancer (BC), intraindividual tumor heterogeneity
is partly driven by hormone receptor conversion between the tumor of
primary site and the BM. e aim of the present study was to evaluate the
prognostic impact of hormone receptor conversion in patients that had
undergone surgery for BM from BC.
Methods: Between 2013 and 2019, 42 patients were surgically treated
for BM derived from BC at the authors neuro-oncological center. Tumor
receptor status (estrogen receptor (ER), progesterone receptor (PR) and
Her2/neu) was assessed histopathologically for the tumor of primary site
and the BM. A multivariable analysis was performed in order to identify
predictors of worsened survival.
Results: Median overall survival for the entire study cohort was 17 months.
Overall, hormone receptor conversion was found in 15 of 42 patients
(36%). Loss of ER and PR was present in 8 of 42 patients (19%), respec-
tively. Gain of Her2/neu was present in 7 patients (17%). Multivariable
analysis revealed gain of Her2/neu as an independent negative prognostic
predictor for increased one-year mortality (Odds ratio 0.1, 95% con-
dence interval 0.01-0.7, p=0.027).
Conclusions: e present study indicates that gain of HER2/neu from
tumor of primary site to BM is associated with elevated one-year mortality
rates and worsened overall survival in patients with BM derived from BC.
Disclosure Statement: e authors declare no conict of interest.
Endocrine Tumors
20
Organoid-associated resistance to antibody-based therapyin
vitrois associated with reduced internalization
Helena Lucius1; Kerstin Wendland1; Anna Ammon1,2; Susanne Pfeer3;
Christian Pilarsky3; Andreas Mackensen1; Fabian Müller1
1Department of internal medicine 5, hematology and oncology; university
hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg
(FAU), Erlangen, Deutschland
2Department of Hematology and Oncology, Medical Faculty, University of
Augsburg, University Hospital Augsburg, Augsburg, Deutschland
3Department of Surgery, university hospital of Erlangen, Friedrich-Alexander
University of Erlangen-Nürnberg (FAU), Erlangen, Deutschland
Background: Neuroendocrine tumors (NET) are a subgroup of neu-
roendocrine neoplasms with limited systemic treatment options in
advanced stage.1 An interesting novel therapeutic approach is the induc-
tion of unfolded protein response using PERK inhibitors,2 which may
induce synergy in combination with a block of protein synthesis by
immunotoxin Hb21.3
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts48
Methods: We used NCI-H720 (lung) and Bon-1 (pancreas) NET cell
lines in monolayer and organoid culture.4 Cells were treated with PERK-
inhibitor, Hb21 or both. Cytotoxicity, surface binding, and internalization
were determined by ow cytometry.
Results: Hb21 induced dose-dependent cell death in NET-monolayer.
Organoids however were resistant to Hb21 treatment. While strong syn-
ergy of Hb21 and PERK-inhibition was found in monolayer, this eect
was absent in organoids. Investigation of resistance to Hb21 revealed that
organoid-specic culture medium (hCPLT) induced similar resistance in
monolayer. Mechanistically, we excluded reduced drug target expression
and target binding as explanations. In contrast, internalization assays
revealed reduced cellular uptake of Hb21.
Discussion: Our results question the role of hCPLT in the use of organoid
cultures when assessing ecacy of therapeutic antibodies. Numerous
components of hCPLT inuence resistance to immunotoxins, suggesting
more than one mechanism of resistance. Reduced internalization may
similarly aect other antibody-based therapies.
Conclusion: e use of organoids as a substitute for in vivo models must
be evaluated with caution. For immunotoxins and possibly for other anti-
body-based therapies, organoids may not be a clinically relevant model.
Indication of source:
1 Scarpa, A. et al. Nature (2017).
2 Moore, P. C. et al.Cancer Res (2019).
3 Gsottberger, F. et al. Cell Death Dis (2023).
4 Baker, L. et al. Tuveson laboratory murine and human organoid protocol
(2017) www.tuvesonlab.labsites.cshl.edu/ (accessed 08/23).
Disclosure Statement: e authors declare the following: FM received Research
Support from MedImmune and Honoraria from AstraZeneca. All other authors do
not have any conict interest.
Epidemiology
236
Causes of death among patients with cancer from
2013 to 2020: A population-based study
Charlotte Gedenk1,2; Anita Feller1; Volker Arndt1,3
1Epidemiological Cancer Registry Baden-Württemberg, German Cancer
Research Center (DKFZ), Heidelberg, Deutschland
2Medical Faculty of Heidelberg, University of Heidelberg, Heidelberg,
Deutschland
3Unit of Cancer Survivorship, German Cancer Research Center (DKFZ),
Heidelberg, Deutschland
Background: Cancer accounts for 22% of all deaths in Germany [1]. With
improving survival rates it is to be expected that other competing causes
of death among cancer patients will become more relevant.
Methods: e mortality pattern of cancer patients was examined using
data from the Cancer Registry of Baden-Württemberg (2013-2020).
Standardized mortality ratios (SMRs) were calculated to assess the
cause-specic mortality in cancer patients in comparison to the general
population.
Result: Out of 144 949 deceased cancer patients 16,2% died from a non-
cancer death (median follow-up [FU] time: 0.87 years). Most frequent
causes were death by ischemic heart disease (17,8%) and other cardio-
vascular diseases (CVD) (18%). In comparison to the general population,
cancer patients were more likely to die from infections (SMR 1.56 [95%-
CI 1,46-1.65]), liver diseases (SMR 2.02 [CI 1.90-2.14]) and suicide (SMR
1.94 [CI 1.76-2.11]). SMRs varied by cancer site with highest SMRs in
lung cancer, especially for CVD and pulmonary diseases. For most tum-
ors, highest SMRs were found in young patients and patients within the
rst year of FU.
Discussion: To our knowledge, this ist the rst study using German data
to examine the risk for noncancer causes of death in oncological patients.
Previous international analyses already reported an increased noncancer
mortality in cancer patients in comparison to the general population.
ese patterns might reect potential therapy related late eects but also
shared risk factors for cancer and other diseases.
Conclusion: Although cancer remains the most frequent cause of death in
oncological patients within the rst years aer diagnosis, cancer patients
are at increased risk regarding competing causes of death such as infec-
tions and suicide. is pattern suggests that an increased awareness of
other competing causes of death in cancer FU and survivorship care
might be warranted.
Indication of source:
1. Statistisches Bundesamt (Destatis). Causes of death by type of disease, 2021.
Disclosure Statement: e authors declare no conict of interest.
249
Epidemiology of malignant pleural mesothelioma in the
federal state of Hesse – a population-based analysis
Isabelle Finke; Soo-Zin Kim-Wanner
Hessisches Krebsregister, Hessisches Landesamt für Gesundheit und Pege,
Frankfurt am Main, Deutschland
Background: Current epidemiologic data of malignant pleural mesothe-
lioma (MPM) are sparse for Germany. e present analysis gives an over-
view of incidence, mortality and prevalence of MPM in the federal state
of Hesse.
Methods: We used data of patients diagnosed with MPM (ICD-10 C45.0)
from the Hessian cancer registry. Crude and age-standardized (old
European standard) incidence and mortality were calculated stratied
by sex and age for the years 2015-2020. Additionally, 1-, 3- and 5-year
prevalence and distributions of cases by morphological subtypes were
computed.
Result: During the six years observation period 552 patients were diag-
nosed and 470 patients died with a diagnosis of MPM. For 2015-2020,
age-standardized incidence for women and men was 0.2 and 1.4 per
100.000, and mortality reached 0.2 and 1.2 per 100.000 for women and
men, respectively. e female to male ratio for incident cases was 1:4. e
1-year prevalence for 2020 was 0.5 and 2.5 per 100.000, 3- year prevalence
for 2018-2020 was 0.8 and 4.4 per 100.000 and 5-year prevalence for 2016-
2020 was 1.0 and 5.1 per 100.000 for women and men, respectively. Both
sexes had a median age at diagnosis of 77 years and median age at death
was 79 years for men and 78 years for women. e proportion of patients
only registered by death certicate (DCO) was high (women: 20.4%, men:
21.6%). For both sexes, the most frequently diagnosed morphologic sub-
type was epithelioid MPM (Epithelioid MPM: women 66.2%, men 54.7%;
biphasic MPM: women 9.5%, men 6.7%; sarcomatoid MPM: women 4.1%,
men 6.1%; MPM not otherwise specied: women 20.3%, men 32.5%).
Discussion: is is the rst analysis showing epidemiologic data of MPM
for the federal state of Hesse. Due to the high proportion of DCO cases,
a survival analysis was not possible. However, the comparison between
mortality and incidence might suggest a poor prognosis compared to
other cancers, which is in line with previous studies.
Conclusion: Our overview showed that MPM is a rare tumour, which
more frequently aects men and patients in advanced age.
Disclosure Statement: e authors declare no conict of interest.
357
Epidemiology of cervical cancer in elderly women in Germany
Sonja Neumeyer; Luana Fiengo Tanaka; Stefanie Klug
Chair of Epidemiology, Department of Sport and Health Science, Technical
University of Munich, Munich, Deutschland
Background: Evidence suggests that the incidence of cervical cancer in
elderly women could be underestimated. Elderly women are more oen
diagnosed with advanced-stage disease and have inferior outcomes com-
pared to younger patients. We investigated incidence, treatment and sur-
vival of cervical cancer in elderly women in Germany.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 49
Methods: e incidence rates of cervical cancer were determined using
data of six federal state cancer registries. Elderly women were dened as
65 years of age and older and compared to younger women. Incidence
was investigated uncorrected and corrected for hysterectomy prevalence
rates. Distribution of treatment modalities such as surgery, chemotherapy,
and radiation therapy were assessed. 5-year relative survival was estimated
using the period approach. Survival was stratied by tumor stage and his-
tological type. Multivariable Cox proportional hazard models were cal-
culated to compare overall survival between younger and elderly women.
Result: In total, 14 528 cervical cancer cases were included in the analyses
with an age range from 20 to more than 85 years of age. Of those, nearly
30% were elderly women aged 65 years or older. Hysterectomy correction
showed that incidence rates were underestimated up to 70% in the oldest
age groups. A lower proportion of elderly women was treated with sur-
gery or chemotherapy. is was found especially in more advanced tumor
stages. Younger patients had a much better 5-year relative survival com-
pared to elderly patients.
Discussion: Cervical cancer incidence in elderly women is underesti-
mated and survival is lower compared to younger women in Germany.
Conclusion: Due to the high disease burden, screening strategies for
elderly women need to be improved.
Indication of source:
1 Neumeyer S, Tanaka LF, Liang LA, Klug SJ. Epidemiology of cervical cancer
in elderly women: analysis of incidence, treatment and survival using German
registry data. Cancer Medicine. 2023; doi: 10.1002/cam4.6318.
Disclosure Statement: e authors declare no conict of interest.
410
Epidemiological study on the occurrence of tumor diseases
among employees of the Ihlenberg landll site
Kirsi Manz; Kerstin Weitmann; Sarah Theen; Gabriele Robers;
WolfgangHomann
Krebsregister Mecklenburg-Vorpommern am Institut für Community Medicine
der Universitätsmedizin Greifswald, Greifswald, Deutschland
Background: Employees at the Ihlenberg toxic waste landll in
Mecklenburg-Vorpommern (MV), which borders Schleswig-Holstein
(SH), were found to be at increased risk of cancer and death from cancer
in a previous cohort analysis covering the years 1983 to 2006. An update
aer two more years showed that the risk was trending downward. Among
other measures, a comprehensive occupational health management pro-
gram was initiated to further protect employees. e continuation of the
study presented here aimed to quantify cancer risk and total mortality in
the employee cohort in recent years using cancer registry data.
Methods: Data on incident cancers among employees were obtained by
linkage with the cancer registries of MV and SH, and data on employee
deaths were obtained from civil registries. Standardized incidence ratios
(SIR) for cancers and standardized mortality ratios (SMR) were calculated
to quantify cancer and mortality risk in the employee cohort. In addition,
the impact of employment duration and latency periods up to 30 years
were considered.
Result: e cohort of 590 employees (432 men, 158 women) who worked
at the landll between 1983 and 2018 for at least 3 months was followed
up until 31.12.2021. With an SIR of 0.71 (95% condence interval (CI):
0.48, 1.00) and SMR of 0.51 (95% CI: 0.35, 0.73), cancer incidence and
total mortality were not increased among employees. Prolonged employ-
ment at the landll was not associated with increased cancer incidence or
mortality. With increasing latency, cancer incidence in the worker cohort
decreased signicantly (p=0.0497 for trend).
Discussion: Compared to the results of the previous studies, the cancer
incidence among the employees has further decreased. One third of the
cohort was followed up for more than 30 years, so that cancers with a
longer latency period were included in the analyses.
Conclusion: e implementation of a comprehensive occupational health
management system and increased employee awareness in handling of
hazardous materials was associated with a decrease in cancer and mortal-
ity rates in the employee cohort.
Disclosure Statement: e authors declare no conict of interest.
481
Update on longitudinal health-related quality of life up to
ve years after radiotherapy in an international multicentre
cohort study in men with non-metastatic prostate cancer
Philipp Heumann1,2; Juan Camilo Rosas Romero1; Miguel
E. Aguado-Barrera3; David Azria4; Erik Briers5; Ananya Choudhury6;
Dirk R. de Ruysscher7; Sara Gutiérrez-Enríquez8; Rudolf Kaaks1;
Maarten Lambrecht9; Carlos López-Pleguezuelos3; Tiziana Rancati10;
Tim Rattay11; Barry S. Rosenstein12; Elena Sperk13; Hilary Stobart14;
Chris Talbot11; Ana Vega15; LIV Veldeman16; Tim Ward14; Adam Webb11;
Catharine ML West6; Jenny Chang-Claude1,17; Petra Seibold1
1Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
2Universität Heidelberg, Medizinische Fakultät, Heidelberg, Deutschland
3Instituto de Investigación Sanitaria De Santiago de Compostela, Santiago de
Compostela, Spanien
4ICM Institut du Cancer Montpellier, Montpellier, Frankreich
5Patient Advocate, Hasselt, Belgien
6The University of Manchester, Manchester, United Kingdom
7Maastro Clinic, Maastricht, Niederlande
8Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital
Campus, Barcelona, Spanien
9KU Leuven, Löwen, Belgien
10Fondazione IRCCS Istituto Nazionale dei Tumori, Mailand, Italien
11University of Leicester, Leicester, United Kingdom
12Mount Sinai School of Medicine, New York, USA
13Mannheim Cancer Center, Universitätsmedizin Mannheim, Medical Faculty
Mannheim, Heidelberg University, Mannheim, Deutschland
14Patient Advocate, London, United Kingdom
15Fundacion Publica Galega Medicina Xenomica, Santiago de Compostela,
Spanien
16Ghent University Hospital, Gent, Belgien
17Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
Background: Analyses of fatigue and global health status in a prostate
cancer (PCa) patient cohort investigating health-related quality of life
(HRQoL) were expanded to include further functional and symptom
scales.
Methods: 1,760 men with non-metastatic PCa recruited between 2014
and 2016 into the observational REQUITE study in 7 European coun-
tries and the USA before radiotherapy (RT; +/- hormonal treatment, +/-
prostatectomy) reported HRQoL at baseline before (N=1,704), at the end
(N=1,647), and annually up to 5 years aer RT (N=518) using the EORTC
QLQ-C30. Normalized mean scores for functioning/symptom scales
(0-100) were calculated, with higher values indicating higher functioning/
symptom burden.
Result: e largest deteriorations pre- vs. post-RT were observed in
diarrhoea, fatigue and role functioning with dierences of 13.7, 9.3, and
6.9 scores, respectively, which returned to baseline levels at 5-years. e
largest proportions of patients with clinically important levels (i.e. above
thresholds proposed in PMID: 31639445) were observed for diarrhoea
(38%) at the end of RT and dyspnoea (30%) 5 years post-RT. While the
proportion for diarrhoea returned to pre-RT levels (11%), consistently
≥23% of long-term survivors reported dyspnoea. Minor score dierences
(below the clinically relevant threshold of 10 scores) were found between
men <70 vs ≥70 years. Compared to European general population data
(PMID: 30576971), PCa patients reported better scores 5 years aer RT
for all scales than men in their age group.
Discussion: For most functioning and symptom scales, post-RT deterio-
ration returned to baseline levels during the 5-year follow-up.
Conclusion: Descriptive analyses of aggregated data suggested an over-
all good HRQoL, however the C30 might not comprehensively capture
unmet health needs in this cohort. To account for intra- and inter-indi-
vidual variability in HRQoL trajectories, growth mixture models adjusted
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts50
for relevant demographic, treatment and tumour-specic covariates to
identify vulnerable subgroups will be presented at the congress.
Disclosure Statement: e authors declare no conict of interest.
495
The incidence and associated factors of second primary
cancers following survival of colorectal cancer – a nationwide
analysis of 217,202 survivors
Linda Liang; Ying-Ju Tseng; Luana Fiengo Tanaka; Stefanie Klug
Chair of Epidemiology, Department of Sport and Health Science, Technical
University of Munich, Munich, Deutschland
Background: With improved survival of colorectal cancer (CRC), the risk
of developing a second primary cancer (SPC) is increasing. Additionally,
CRC is increasing in younger populations (<50 years). We determined the
incidence and potential associated factors of SPC following CRC.
Methods: CRC cases (ICD-10 C18-C20) aged ≥20 years (diagnosed in
1990-2011) from the German Centre for Cancer Registry Data (ZfKD)
were extracted. SPC was dened as any subsequent cancer diagnosed
(excluding non-melanoma skin cancer) until the end of 2013 with a
dierent histological group. Incidence was calculated as standardized
incidence ratios (SIR) and 95% condence intervals (CI) were Poisson
distributed. Cause-specic Cox regression examined associated factors of
SPC, accounting for death as a competing risk.
Result: Of 217,202 CRC cases included (median age 70 years), 18,751
SPCs occurred (8.63%). In males and females, SPC risk increased by 36%
(SIR: 1.36 [95% CI 1.34-1.38]) and 46% (SIR: 1.46 [95% CI 1.43-1.49])
respectively. SPC incidence was almost four-fold for survivors <50 years
compared to the respective general population (SIR males: 4.51 [95% CI
4.04-5.01]; females: 4.03 [95% CI 3.62-4.48]). Risk of SPC (all ages) fol-
lowing both colon cancer (CC) and rectal cancer (RC) was increased in
the digestive, urinary, female and male reproductive organs. Smaller pri-
mary tumor size and right-sided CRC were associated SPC risk factors.
Treatment of CC was not associated with SPC but the risk was lowered for
RC aer chemotherapy.
Discussion: CRC survivors, particularly younger cases, are at increased
risk of SPC. Primary tumor-related characteristics were associated risk
factors.
Conclusion: Our ndings may guide tailored screening of CRC survivors.
Indication of source:
1 Liang, LA, Tseng, Y-J, Tanaka, LF, Klug, SJ. Second primary cancer among
217702 colorectal cancer survivors: An analysis of national German cancer
registry data. International Journal of Cancer. 2023; 1–13. doi:10.1002/ijc.34638.
Disclosure Statement: e authors declare no conict of interest.
496
Risk Estimation for Second Primary Lung Cancer in German
Lung Cancer Survivors Based on Tumor Histology
Marian Eberl1; Klaus Kraywinkel2; Luana Fiengo Tanaka1; Stefanie Klug1
1Chair of Epidemiology, Department of Sport and Health Science, Technical
University of Munich, Munich, Deutschland
2Robert Koch Institut, German Center for Cancer Registry Data, Berlin,
Deutschland
Background: e published standardized incidence ratios (SIR) for lung
cancer (LC) aer lung cancer are unexpectedly low in Germany (1). ese
might be underestimated in registries that use IARC multiple primary
due to the histology-dependent documentation of secondary primary
cancer (SPC) with the same location as the rst cancer. is study aims to
improve the estimation of SIR for second primary lung cancer (SPLC) in
German LC survivors using histology-specic reference rates.
Methods: We use data of German LC survivors from 11 regional can-
cer registries diagnosed between 2002 and 2013. We present updated risk
estimates for SPLC using a novel method to calculate histological sub-
type-specic SIRhist and compare results to the traditional SIR.
Result: In total, 154 women and 388 men (0.4% of patients) of the
included 135,572 LC survivors have developed an SPLC. e adjusted rel-
ative risk of developing an SPLC was 2.98 (95% CI: 2.53–3.49) for females
and 1.15 (95% CI: 1.03–1.27) for males. e histological subtypes of index
LC with the highest SIR was squamous cell carcinoma (SIRhist = 5.17, 95%
CI: 3.94–6.67) in women and small-cell carcinoma (SIRhist = 1.36, 95% CI:
0.99–1.81) in men.
Discussion: Our newly developed method of histology-specic SIR can
reduce bias when estimating the risk of same-site SPC. e adjusted esti-
mates for the risk of SPLC in LC survivors are substantially higher than
previously published unadjusted SIR.
Conclusion: Our ndings impact the international comparison of SPC
rates using cancer registry data, particularly regarding estimations follow-
ing IARC versus SEER rules.
Indication of source:
1 Eberl M, Tanaka LF, Kraywinkel K, Klug SJ. Incidence of Smoking-Related
Second Primary Cancers Aer Lung Cancer in Germany: An Analysis of
Nationwide Cancer Registry Data. J orac Oncol. 2022;17(3):388–98.
Disclosure Statement: e authors declare no conict of interest.
503
Semi-quantitative assessment of environmental
tobaccosmoke exposure and its association with the
development oforal squamous cell carcinoma: A pilot study
Susanne Wolfer1; Henning Schliephake1; Thomas Asendorf2;
PhilippKaumann1
1Universitätsmedizin Göttingen Abteilung für Mund-, Kiefer- und
Gesichtschirurgie, Göttingen, Deutschland
2Institut für Medizinische Statistik - UMG, Göttingen, Deutschland
Purpose: Environmental tobacco smoke (ETS) is considered as a health
risk factor and has been proven to be associated with the occurrence of
various diseases (1-3). An individual assessment of exposure to ETS was
not done so far. is study intends to numerically record and evaluate the
exposure to lifelong ETS using the oral squamous cell carcinoma (OSCC)
as a smoke-related carcinoma.
Methods: Using a standardized questionnaire, 165 cases and 167 controls
were asked about their risk behaviors, including ETS exposure. An ETS-
score was developed to semi-quantitatively record the exposure to ETS.
Statistical descriptive and explorative analyses were performed.
Result: Cases had an increased ETS exposure compared to the controls
(ETS-score: 36.69 vs 13.92; p<0.0001). In the cases, there was a clear
increase in the ETS-score with increasing risk behavior (p<0.0067).
Signicant dierences in ETS-score were found for dierent tumor loca-
tions (p=0.0012) and histopathological gradings (p=0.0399). ETS expo-
sure was conrmed as an independent risk factor for developing OSCC
(p<0.0001).
Discussion: A recent review conrms that passive smoking inuences the
development of OSCC (4). However, there was no individual recording of
ETS exposure. We even found an increased risk by 1% with an increasing
ETS-score by 1 point. is has never been reported in the literature and
shows the good functionality of the score.
Conclusion: e presented ETS-score has shown to be a sensitive meas-
ure for assessment of ETS exposure. Further studies are needed for con-
rmation and validation of the usefulness of the ETS-score as a numerical
measurement of ETS exposure. is ETS-score could be used as an easy-
to-use instrument in everyday clinical practice for the detection of other
diseases possibly associated with ETS.
References:
1. Ni X et al. Int J Environ Res Public Health. 2018 Jun 27;15(7):1348.
2. Luo J et al. BMJ. 2011 Mar 1;342:d1016.
3. Wang Y et al. PLoS One. 2013 Jul 26;8(7):e69915.
4. Mariano LC et al. Tob Control. 2022 Sep;31(5):597–607.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 51
644
Cancer-related fatigue at the end of radiotherapy as a
prognostic factor for 10-year overall survival in women
with breast cancer
Philipp Heumann1,2; Axel Benner1; Sabine Behrens1;
Jenny Chang-Claude1,3; Petra Seibold1
1Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
2Universität Heidelberg, Medizinische Fakultät, Heidelberg, Deutschland
3Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
Background: e prognostic value of severe cancer-related fatigue (CRF)
at the end of radiotherapy (RT) for 10-year overall survival was inves-
tigated in a cohort of women with non-metastatic breast cancer (BCa).
Methods: Data from the prospective multicentre ISE study were ana-
lysed, which enrolled women with non-metastatic BCa aer breast-con-
serving surgery and before RT without chemotherapy between 1998 and
2001 in the Rhine-Neckar-Karlsruhe region in Germany. A vital status
follow-up was conducted in 2019 (median follow-up: 19 years). Health-
related quality of life was collected at the end of RT using the EORTC
QLQ-C30 and normalised to scores from 0-100. Severe CRF 2 to 6 weeks
aer RT was classied as ≥39 scores using the threshold of clinical impor-
tance (PMID31639445). Overall survival was dened as the time from
CRF assessment to death, with events censored aer 10 years of follow-up.
Hazard ratios (HR) and 95% condence intervals [95% CI] were derived
from a Cox regression model adjusted for CRF, age, BMI at surgery, T stage,
lymph node involvement, grading and receptor status.
Result: Of 437 patients with fatigue assessments, 164 (38%) reported clin-
ically important severe CRF. During the 10-year follow-up, 23 patients
without (46%) and 27 patients with CRF (54%) died. CRF was modelled
with a step function at 5 years of follow-up due to non-proportional haz-
ards. T stage (HR: 3.02 [1.69, 5.38]), nodal involvement (HR: 2.56, [1.41,
4.65]) and age (HR: 1.05 [1.02, 1.09]) were signicantly associated with
overall survival. For CRF, a statistically signicant eect was observed for
≥5 years of follow-up (HR: 2.44 [1.12, 5.32]), but not for <5 years (HR:
1.26 [0.56, 2.84]).
Discussion: Further analyses will be presented at the conference, extend-
ing the follow-up period and exploring whether other patient-reported
outcomes such as global health status are prognostic for survival.
Conclusion: Beyond established prognostic factors of tumour size, nodal
involvement and age, severe CRF aer RT was associated with lower over-
all survival aer ≥5 years of follow-up.
Disclosure Statement: e authors declare no conict of interest.
651
Signicant Underestimation of Preventive Eects in Colorectal
Cancer Screening Trial
Thomas Heißer; Michael Homeister; Hermann Brenner
Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
Background: Follow-up results of the randomized NordICC trial revealed
a presumably smaller than expected protective eect of screening colonos-
copy to prevent colorectal cancer (CRC). However, measured incidence
reduction is biased due to inclusion of preclinical cases already present at
recruitment, which can no longer be prevented. We aimed to quantify the
true impact of screening colonoscopy in NordICC.
Methods: Using a thoroughly validated modelling approach, we repli-
cated NordICC by matching simulated subjects with reported numbers,
and derived expected incidence aer excluding cases that manifested
during follow-up but were already prevalent at baseline. Key outcomes
were the adjusted (i.e., unbiased, excluding prevalent cancers at baseline)
and observed (i.e., as reported) risk ratios (IRR) for screening versus no
screening.
Result: Driven by the inclusion of a large proportion of prevalent can-
cers, observed cumulative incidence was higher in the screening versus
control group in the initial years aer randomization. With increasing
length of follow-up, observed cumulative incidence was lower in those
screened. However, this incidence reduction was still much lower than
adjusted incidence reduction due to inclusion of prevalent cases in calcu-
lation of observed cumulative incidence. In intention-to-screen analysis
observed/adjusted risk reductions aer 6, 8 and 10 years of follow-up were
5%/32%, 13%/31%, and 17/30%, respectively. In per-protocol analysis,
respective observed/adjusted risk reductions were 12%/75%, 29%/73%,
and 39%/70%.
Conclusion: e preventive eect of screening colonoscopy is likely much
stronger than reected in reported RRs. Published ndings of NordICC
signicantly underestimate the true preventive eective of screening colo-
noscopy even aer 10 years of follow-up.
Disclosure Statement: e authors declare no conict of interest.
656
Projected patient numbers of (HER2+) metastatic gastric
cancer (mGC) in the German statutory health insurance (SHI):
A claims data analysis
Jaime Luna1; Jürgen Hess2; Magnus Lutz2; Bernhard Mörtl2; Nils Picker3;
Thomas Wilke4; Yan Xiong5; Thorsten Götze6
1Cytel, Berlin, Deutschland
2Daiichi-Sankyo Deutschland, München, Deutschland
3Cytel, Wismar, Deutschland
4IPAM, University of Wismar, Wismar, Deutschland
5Daiichi-Sankyo Inc, Basking Ridge, USA
6Krankenhaus Nordwest, Frankfurt, Deutschland
Background: Gastric cancer is one leading cause of cancer-related mor-
tality in Germany. Innovative therapies recently changed the treatment
landscape in the metastatic setting. is study aimed to estimate the
number of (HER2+) mGC patients (pts) per line of treatment (LOT) in
German SHI to support registry information with real-world data.
Methods: A retrospective analysis was conducted using anonymized
German claims data (AOK PLUS; ~3.5M insured individuals) estimating
pt numbers from 2011 to 2020. mGC pts were identied via ICD-code;
HER2+ mGC pts by a treatment proxy (trastuzumab). e age and sex-
adjusted SHI projection was performed per calendar year and stratied
per LOTs.
Result: e study cohort consisted of 2.629 mGC pts treated in 1LOT
(mean age 68.3; male 66.3%). Of those pts, 38.2% switched to 2LOT
(n=861), and 10.2% reached 3LOT (n=268). e HER2+ cohort consisted
of 214 mGC pts (mean age 67.5 years; male: 74.3%), 54.7% switched to
2LOT (n=117), and 27.1% reached 3LOT (n=58). e mean number of
mGC cases projected on SHI population over the last 5 years 2016-2020
starting 1LOT annually was 7.119 (2016: 5.789, 2017: 7.122, 2018: 7.250,
2019: 7.412, 2020: 8.024); 2.585 for 2LOT (2.409, 2.603, 2.349, 2.662,
2.901) and 920 for 3LOT (655, 1.064, 839, 1.005, 1.035). e mean num-
ber of estimated HER2+ cases in the SHI starting 1LOT was 576 (565, 441,
687, 673, 516); 362 for 2LOT (193, 298, 390, 500, 429) and 190 for 3LOT
(160, 236, 138, 300, 117).
Discussion: Epidemiological registries rarely include data on clinical var-
iables, diagnostic testing, or shares in LOT. German SHI data analyses can
help to close this gap. In this study, the projected mGC numbers in 1LOT
are slightly higher than expected. For mGC pts in ≥2LOT or the HER2+
cohort, the projections are consistent with registry and literature based
estimations.
Conclusion: is study provides valuable insights into mGC numbers.
Further improvement of available data in Germany, including data-link-
age of SHI and registry data, is needed to provide comprehensive informa-
tion on both epidemiological and clinical research questions.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts52
829
The Rising Incidence of Early-Onset Colorectal Cancer
Stefanie Klug1; Nina Buttmann-Schweiger2; Luana Fiengo Tanaka3;
Vera Popova4; Sieglinde Hechenbichler Figueroa5
1TU München, Fakultät für Sport- und Gesundheitswissenschaften, München,
Deutschland
2Robert Koch Institut, Zentrum für Krebsregisterdaten, Berlin, Deutschland
3TU München, Fakultät für Sport- und Gesundheitswissenschaften, München
4München, Deutschland
5TU München, München, Deutschland
Background: e incidence of colorectal cancer diagnosed before the age
of 50 (early onset, EO-CRC) is increasing in some high-income countries.
In the present study, this trend was analyzed for Germany (1).
Methods: e Center for Cancer Registry Data (ZfKD) provided data on
the incidence of colorectal cancer (ICD-10 C18-C20) from German epi-
demiological state cancer registries with sucient coverage during 1999-
2018. Cases identied only by death certicates were excluded. Mortality
data were taken from ocial cause-of-death statistics. Temporal trends
were presented as average annual percentage change (AAPC) with 95%
condence intervals. Incidence was reported stratied by sex and site of
occurence (proximal colon, distal colon, and rectum), 10-year age group
(20-29, 30-39, and 40-49), and tumor size (T).
Results: 5.1% (9 529 cases) of all colorectal cancer cases in the selected
German regions were diagnosed before the age of 50 years. e incidence
of EO-CRC increased annually by 1.16% (95-% condence interval: 0.51;
1.81) in men and by 1.32% [0.80; 1.84] in women. e incidence of cancer
in the proximal colon increased in both sexes (men AAPC: 3.26% [2.00;
4.53]; women AAPC: 2.99% [2.17; 3.83]), whereas the incidence of cancer
in the distal colon remained stable.
Discussion: Increasing incidence of EO-CRC has been identied in at
least 19 high-income countries, with the greatest yearly changes seen in
New Zealand, the UK, Canada, and Australia. e overall annual increase
found in Germany by this study is less pronounced, but similar to the
gures re-ported for Sweden, Denmark, and Slovenia.
Conclusion: e incidence of EO CRC is increasing in Germany. e rea-
sons are probably multifactorial and reect the changing prevalence of
risk and protective factors one is exposed to in early life.
Indication of source:
1 Dtsch Arztebl Int 2023; 120: 59–64. DOI: 10.3238/arztebl.m2022.0368.
Disclosure Statement: e authors declare no conict of interest.
853
Occurrence of cancer in people with intellectual disabilities in
Germany in 2019
Andreas Berger1; Marie-Luise Rosenbusch2; Ramona Hering2;
MandySchulz2; Christoph Kowalski3; Nora Tabea Sibert3;
Thomas Seuerlein4; Tanja Sappok5
1Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Klinik für
Innere Medizin II, Berlin, Deutschland
2Zentralinstitut für die kassenärztliche Versorgung in der Bundesrepublik
Deutschland, Berlin, Deutschland
3Deutsche Krebsgesellschaft e. V., Versorgungsforschung, Berlin, Deutschland
4Universitätsklinikum Ulm, Klinik für Innere Medizin I, Ulm, Deutschland
5Universitätsklinikum OWL der Universität Bielefeld, Krankenhaus Mara gGmbH
– Universitätsklinik für Inklusive Medizin, Bielefeld, Deutschland
Background: Approximately 0.5-1 million people with an intellectual
disability (ID) life in Germany with reduced life expectancy, namely due
to malignancy (20%). Data on cancer prevalence of people with ID in
Germany are not yet available.
Methods: Relative risk for various cancer diagnoses (ICD-10: C00-C97;
M1Q, secured) in people with/without ID (age/sex/district-matched) in
nationwide outpatient billing data of all statutory health insurance patients
(0-107 years) in 2019 were analyzed. Ethics vote of the ethics committee of
the Berlin Medical Association is available (Eth-11/23).
Result: ere were data of 438.028 people with ID (F70-79, M2Q inclu-
sion diagnoses) and 65.762.146 people without ID, in 2019. Aer match-
ing for age, sex, and district code, data from 437.802 people with ID and
4.378.020 without ID (0-95 years, male/female) were available. Data from
16.133 people with ID and cancer and 201.369 with cancer but without
ID were analyzed. Univariate Odds Ratios (OR) were calculated. Across
all cancers, people with ID showed lower risks for a cancer diagnosis
(OR 0.83; 95% Condence Interval [95% CI] 0.82-0.84). Certan cancers
occurred more oen, such as malignant neoplasms of the brain (C71; OR
2.80; 95% CI 2.58-3.03), spinal cord, cranial nerves and other parts of the
central nervous system (C72 ; OR 2.45; 95% CI 1.76-3.34), testicles (C62;
OR 1.80; 95% CI 1.68-1.93), corpus uteri (C54; OR 2.02; 95% CI 1.86-
2.19), and leukemia (C95; OR 1.86; 95% CI 1.67-2.06). However, other
entities such as malignant melanoma type (C43; OR 0.55; 95% CI 0.51-
0.59) or GI tumor type (C15-26; OR 0.90; 95% CI 0.86-0.94) occurred
less oen.
Discussion: People with an ID showed a decreased risk for being diag-
nosed with cancer, may be due to diculties in accessing the health sys-
tem and lower cancer screening rates and hereby lead to lower prevalence
rates in this nationwide sample.
Conclusion: Medical services and screening programs for people with ID
need to be built-up, adapted and expanded to meet the needs of people
with ID.
Disclosure Statement: e authors declare no conict of interest.
Epigenetic and Metabolomic Targets
901
HDAC inhibitors activate lipid peroxidation and ferroptosis in
gastric cancer
Robert Georg Jenke1,2,3; Denys Oliinyk3,4; Justus Körfer1,5; Linda
Schäker-Hübner6; Ingo Bechmann5; Finn K. Hansen6; Florian Lordick1,3;
Florian Meier-Rosar3,4; Achim Aigner2; Thomas Büch2
1University Cancer Center Leipzig (UCCL), University Hospital Leipzig, Leipzig,
Deutschland
2Leipzig University, Medical Faculty, Rudolf-Boehm-Institute for Pharmacology
and Toxicology, Clinical Pharmacology, Leipzig, Deutschland
3Comprehensive Cancer Center Central Germany (CCCG), Leipzig and Jena,
Deutschland
4Jena University Hospital, Functional Proteomics, Research Center Lobeda, Jena,
Deutschland
5University Hospital Leipzig, Institute for Anatomy, Leipzig, Deutschland
6University of Bonn, Pharmaceutical Institute, Department of Pharmaceutical
and Cell Biological Chemistry, Bonn, Deutschland
Background: Gastric cancer remains one of the deadliest neoplasms
worldwide, with a high need for new therapeutic options. Ecacies of tar-
geted therapies are oen limited owing to the inter- and intratumoral het-
erogeneity of gastric cancer. us, drugs with broader impact on multiple
pathways might provide a substantial benet over the inhibition of only
a single oncogene. Preclinical studies have identied histone deacetylases
(HDAC) and their respective isoforms as potential therapeutic targets in
gastric cancer. Since clinical ecacies have been moderate, the mecha-
nism(s) of action of HDAC inhibitors (HDACi) need further investigation.
Methods: In a panel of gastric cancer cell lines tumor cell inhibitory eects
of dierent HDACi were studied. Lipid peroxidation levels were measured
using ow cytometry. Proteome analysis was performed for the in-depth
characterization of molecular alterations upon HDAC inhibition. HDACi
eects on important ferroptosis genes were validated on the mRNA and
protein level.
Result: Upon HDACi treatment, lipid peroxidation levels were increased
in all tested cell lines. Proteome analysis revealed signicant and concord-
ant alterations in the expression of proteins involved in the ferroptosis
pathway. Key enzymes like ACSL4, POR or SLC7A11 showed distinct
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 53
alterations in their expression patterns, providing an explanation for the
increased lipid peroxidation. Alterations of mRNA expression of POR and
SLC7A11 levels upon treatment were also examined in primary human
gastric cancer tissue cultures.
Discussion & Conclusion: Ferroptosis is involved in the antitumor eects
of HDAC inhibitors in gastric cancer while this occurs via downregulat-
ing anti-ferroptotic and upregulating pro-ferroptotic enyzmes. We iden-
tify the induction of ferroptosis as a new mechanism of action of class-I
HDACi in gastric cancer, independent of the genetic background of the
cell lines. We therefore introduce lipid peroxidation as a new general eect
of HDACi induced anti-tumor eects.
Disclosure Statement: e authors declare no conict of interest.
Gastrointestinal Cancer: Colorectal
79
Comprehensive proling of broblasts reveals the origin
andactivation of disease-promoting subtypes in human
colorectal cancer
Richard Demmler1; Charles G. Anchang2; Yong S. Yong1; Simon Rauber3;
Benjamin Schmid4; Vera S. Schellerer5; Elisabeth Naschberger1;
AndreasRamming3; Michael Stürzl1
1Universitätsklinikum Erlangen, Division of Molecular and Experimental Surgery,
Erlangen, Deutschland
2Vindex GmbH, Potsdam, Deutschland
3Universitätsklinikum Erlangen, Department of Medicin 3, Erlangen
4Optical Image Centre Erlangen, Erlangen, Deutschland
5Universitätsklinikum Greifswald, Department of Visceral Surgery, Pediatric
Surgery, Greifswald, Deutschland
Background: Cancer-associated broblasts (CAFs) are a major player in
the architecture of the tumor microenvironment (TME) and the progres-
sion of cancer. CAFs are phenotypically heterogeneous. Several CAF sub-
types were proposed, including inammatory CAFs and myobroblastic
CAFs, but a precise characterization of their stability and function in can-
cer remains unclear1. Buechler et al. proposed a PI16-expressing subtype
as the unspecialized normal broblast (NAF) state from which dierent
activated phenotypes can arise2. e goal of this study is to give a more
precise look into the dierent subtypes of CAFs and their respective func-
tions in colorectal cancer (CRC).
Methods: Bulk/Single-cell RNA Sequencing, Western Blot, qPCR, IHC, ICC
Result: Bulk RNA Sequencing of isolated and cultured broblasts of
human colorectal cancer (n=6) and healthy colon (n=3) revealed a sta-
ble NAF and CAF signature which is preserved in vitro. Findings were
conrmed by Western Blot, qPCR and Immunohistochemical stain-
ings. Four major subtypes could be identied in normal colon and CRC
using a public single-cell RNA Seq dataset of CRC3. NAF activation into
Myobroblasts was achieved via TNF-α and TGF-β stimulation and went
along with the loss of the NAF signature.
Discussion: Here isolated primary CAFs and corresponding NAFs from
human CRC were established to study their role in the disease. Stable sub-
types of broblasts were preserved in cell culture and portrayed based on
their transcriptome and function. e existence of the PI-16 subtype was
conrmed in cultured NAFs and further characterized. e activation of
this subtype into cancer-promoting subtypes was recreated in vitro.
Conclusion: We determined major dierences between cultured CAFs
and NAFs of human CRC and identied disease-relevant subpopulations
originating from an unspecialized normal broblast population.
References:
1. Öhlund D. et al., J Exp Med 2017.
2. Buechler M. B. et al., Nature 2021.
3. Lee, H. O. et al., Nat Genet 2020.
Disclosure Statement: e authors declare the following: C.G.Anchang is aliated
with VINDEX GmbH.
91
The patient-derived cancer spheroid model predicts response
to chemotherapy in curatively resected patients with high-risk
stage II and stage III colon cancer
Barbara Mayer1; Isabella Held1; Kathrin Halfter2; Jens Werner1
1Department of General, Visceral and Transplantation Surgery, LMU University
Hospital, LMU Munich, München, Deutschland
2The Institute for Medical Information Processing, Biometry and Epidemiology,
LMU Munich, München, Deutschland
Background: e prospective SpheroPCT cohort study was conducted
to evaluate the chemopredictivity of the patient-derived cancer spheroid
model (PDCS) in locally advanced CRC.
Methods: Tumor spheroids were prepared from 48 colorectal can-
cer patients (R0M0) with UICC-II high-risk and UICC-III tumors for
48 h and treated with guideline-recommended chemotherapy for 72 h.
Treatment ecacy was measured by ATP luminescence assay and multi-
variately correlated with 5-year disease-free survival (DFS).
Result: CRC patients treated according to the most eective test results
did not experience tumor recurrence within the 5-year follow-up (32 of
36 patients, 88.9%). In contrast, tumor recurrence occurred in patients
who did not receive the best therapy suggested by the PDCS model (7
of 12 patients, 58.3%, p<0.001). Drug testing in the PDCS model proved
to be an independent predictor of drug response (HR 0.191, 95% CI
0.045-0.801, p=0.024). Test specicity was calculated to be 86.5% and test
sensitivity was calculated to be 74.6%. Consistent with guideline recom-
mendations, drug testing in the PDCS model showed no improvement in
treatment ecacy with the addition of irinotecan to 5-FU or cetuximab
to 5-FU in combination with oxaliplatin (FO). In six of the 11 relapsed
patients (54.5%), the test detected a more eective treatment option than
the given one. Two CRC patients were classied as chemoresistant. For
nine of 13 patients (69.2%) who required reduction of standard chemo-
therapy with FO due to severe side eects, the PDCS model identied an
equivalent or more eective treatment option.
Discussion: e data suggest that preclinical drug testing in the predictive
PDCS model should be translated to clinical practice. is strategy could pro-
vide more eective and less toxic therapeutic options for individual cancer
patients, resulting in prolonged survival and improved quality of life.
Conclusion: e patient-derived cancer spheroid model supports deci-
sion making in personalized cancer therapy.
Disclosure Statement: e authors declare no conict of interest.
230
Inuence of laparoscopic versus open surgery on humoral
immunity in patients with colorectal cancer: a systematic
review and meta-analysis
Annika Bohne1; Elena Grundler1; Helge Knüttel1; Vinzenz Völkel3;
AloisFürst4
1Universität Regensburg, Regensburg, Deutschland
2Tumorzentrum Regensburg, Zentrum für Qualitätssicherung und
Versorgungsforschung der Universität Regensburg, Regensburg, Deutschland
3Caritas-Krankenhaus St. Josef, Klinik für Allgemein-, Viszeral-, Thoraxchirurgie
und Adipositasmedizin, Regensburg, Deutschland
Background: Laparoscopic surgery (LS) and open surgery (OS) are the
main surgical treatment options for colorectal cancer (CRC), which might
dier in their impact on host immunity so indispensable for anti-infectious
and antitumor defence.
Methods: Included in this systematic review and meta-analysis were
randomized controlled trials (RCTs) measuring parameters of humoral
immunity up to eight days aer LS compared to OS in adult patients
with CRC of any stage. MEDLINE, Embase, Web of Science (SCI-
EXPANDED), Cochrane Library, Google Scholar, ClinicalTrials.gov and
ICTRP were systematically searched. Risk of bias (RoB) was assessed
using the Cochrane RoB2 tool. Random-eects meta-analysis of mean
dierences (MD) was performed. Methods were prospectively registered
in PROSPERO (CRD42021264324).
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts54
Result: Twenty RCTs with 1,131participants were included. RoB was rated
low in ve, of some concerns in 13, and high in two studies. Quantitative
synthesis found concentrations of parameters to be signicantly lower
aer LS for IL-6 and CRP at 3-9h (CRP MD -1.67 mg/dl 95% CI [-3.25,
-0.08] p=0.04, IL-6 -86.71 pg/ml [-125.05, -48.37] p<0.00001), at post-
operative day (POD) 1 (CRP -3.68 mg/dl [-5.05, -2.32] p<0.00001, IL-6
-26.88 pg/ml [-31.27, -22.50] p<0.00001) and at POD 2 (IL-6 -11.47 pg/ml
[-16.32, -6.63] p<0.00001). IL-8, TNFα and VEGF also showed lower con-
centrations aer LS at 0-2h (IL-8), 3-9h (IL-8, TNFα) and POD 1 (IL-8,
VEGF). No meta-analysis yielded results favouring the OS group.
Discussion: e increase in postoperative concentrations of several
proinammatory parameters was signicantly less pronounced aer LS
in the analyses, especially in the early postoperative period up to POD1.
e main limitations of the included RCTs were small sample sizes and a
heterogenous choice of measuring timepoints.
Conclusion: e summarized evidence favours the laparoscopic approach
over the open approach in regard to a milder postoperative proinamma-
tory reaction, although further research is desirable.
Disclosure Statement: e authors declare no conict of interest.
253
Does the Prognosis of Colorectal Cancer Depend on the
Age of Onset?
Caroline Deutschmann; Lutz Mirow; Hagen Rudolph
Allgemein- und Viszeralchirurgie Klinikum, Chemnitz, Deutschland
Background: Colorectal cancer (CRC) is one of the most frequent tumor
entities in Germany. Less than 10% of all patients are under 50 years of
age. But several studies expect an increase in the incidence rate in this
age group.
In this paper I study its prognosis depending on the age of its onset in
patients.
Methods: I conducted a retrospective data analysis of all surgical primary
cases with colon or rectal carcinoma at Klinikum Chemnitz diagnosed
between 01/01/1995 and 12/31/2020. ese included the diagnostic codes
C18.-, C19 and C20 of ICD-10-GM-2021. Applying an age lter of “50
years or younger” and “70 years or older”, I evaluated a number of 1381
cases. e nal data for this study was compiled on 11/10/2021.
Result: Patients at 50 years or younger showed a pUICC stage III or IV
(57.6%) at the time of diagnosis. e cohort of 70 years or older was
mostly diagnosed at pUICC stage I or II (54.2%).
e share of patients in stage R2a (macroscopically discernible residual
tumor) was signicantly higher in the cohort of up to 50 years (20.5%;
≥70 years: 12.8%).
Noticeably, younger CRC patients showed more general recurrences
(≤ 50 years: 31.1%; ≥ 70 years: 13.8%), local recurrences (≤ 50 years: 15,9%;
≥ 70 years: 5.0%) and metastases (≤ 50 years: 51.5%; ≥ 70 years: 28.8%).
Up to this study‘s reference day, 47.0% of the cohort of 50 years or younger
had died. In 32.6% of these cases the tumor was the cause of death. e
cohort of 70 years or older showed 69.7% deaths, but only 29.8% were
caused by the tumor.
Discussion: Assumed causes for the progressed pUICC stage as well as
the higher recurrence and metastasis rates with younger patients are:
delayed diagnosis with unspecic symptoms appearing late, more aggres-
sive tumor biology, eects due to the birth cohort with a higher prevalence
of antibiotics medication and obesity as well as hereditary syndromes.
Conclusion: e comparatively high rate of death in patients up to
50years of age caused by a tumor indicates, that younger CRC patients
have worse prospects of survival.
Disclosure Statement: e authors declare no conict of interest.
316
An almost insurmountable immunologic barrier: A detailed
view on the interaction of hypermutated colon cancer with
autologous T cells
Sandra Schwarz1; Su Zhaoran1; Mathias Krohn1; Markus Löer2;
Andreas Schlosser3; Michael Linnebacher1
1Universitätsmedizin Rostock, Klinik und Poliklinik für Allgemein-, Viszeral-,
Thorax-, Gefäß- und Transplantationschirurgie, Molekulare Onkologie und
Immuntherapie, Rostock, Deutschland
2Universität Tübingen, Institut für Zellbiologie, Immunologie, Tübingen,
Deutschland
3Universität Würzburg, Rudolf-Virchow-Zentrum, Center for Integrative and
Translational Bioimaging, Würzburg, Deutschland
Background: e interaction of cancer and immune cells is still not com-
pletely resolved. us, we selected two colon cancer cases with patient-
derived cell lines, peripheral and tumor-inltrating T cells available for
detailed investigation.
Methods: Prior to co-culture, T cell populations were characterized
regarding immune checkpoint (PD-1, CTLA-4, LAG-3) expression and
the amount of regulatory T cells. Tumor cell line analysis covered tumor
mutational burden, antigen processing and presentation, and immune
checkpoint ligands (PD-L1, CD80/86). Aer co-culture experiments, a
degranulation assay determined tumor cell recognition.
Result: T cells co-cultured with autologous tumor cells showed only low
levels of pro-inammatory cytokines and failed at tumor recognition.
Since antigen presentation was not aected in tumor cells, we assumed
active immunosuppressive tumor cell mechanisms. Yet, the treatment
of co-cultures with immune checkpoint inhibitors (ICI) did not boost
anti-tumor immune responses. Only pre-stimulation of T cells with
tumor-specic peptides signicantly increased tumor cell recognition.
Above all, this eect was higher in peripheral than in tumor-inltrating
T cells. Further characterization of the tumor cells revealed expression
of granzyme B and proteinase inhibitor 9 (PI-9), granzyme Bs specic
inhibitor. However, in a nal cytotoxicity assay, tumor cell elimination was
signicantly higher in peptide-stimulated than control T cells and neither
ICI nor PI-9 inhibitor further improved the outcome signicantly.
Discussion: ese results prove the complexity of immune evasion and
suppression mechanisms active in tumor cells. ey further underline
the importance of more personalized approaches in future immunothera-
pies and they also demonstrate the superiority of tumor-naïve peripheral
blood T cells compared to highly exhausted tumor-inltrating T cells.
Conclusion: Tumor cells use a complex network of immunosuppressive
strategies and multimodal immunotherapeutic approaches are needed to
overcome these barriers.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 55
388
COLUMBUS 7-Year Update: A Randomized, Open-Label,
Phase 3 Trial of Encorafenib (ENC) + Binimetinib (BIN) vs
Vemurafenib (VEM) or ENC in Patients (Pts) With
BRAFV600-Mutant Melanoma
Dirk Schadendorf1; Reinhard Dummer2; Keith T. Flaherty3;
CarolineRobert4; Ana Arance5; Jan Willem B. de Groot6; Claus Garbe7;
Helen J. Gogas8; Ralf Gutzmer9; Ivana Krajsová10; Gabriella Liszkay11;
Carmen Loquai12; Mario Mandalà13; Naoya Yamazaki14; Carolin Guenzel15;
Anna Polli16; Mahgull Mahgull17; Alessandra DI Pietro18; Paolo A. Ascierto19
1University Hospital Essen, West German Cancer Center and German Cancer
Consortium, Partner Site Essen, Essen, Deutschland
2Universitätsspital Zürich, Dermatologische Klinik, Zürich, Schweiz
3Massachusetts General Hospital, Harvard Medical School, Boston, USA
4Gustave Roussy and Paris-Saclay University, Villejuif, Frankreich
5Hospital Clinic of Barcelona and IDIBAPS, Barcelona, Spanien
6Isala Oncology Center, Zwolle, Niederlande
7University Hospital Tubingen, Tübingen, Deutschland
8National and Kapodistrian University of Athens, Athens, Griechenland
9Hannover Medical School and Ruhr-University Bochum, Minden, Deutschland
10University Hospital Prague, Prag, Tschechische Republik
11National Institute of Oncology, Budapest, Ungarn
12University Medical Center of the Johannes Gutenberg University Mainz, Mainz,
Deutschland
13University of Perugia, Perugia, Italien
14National Cancer Center Hospital, Tokio, Japan
15Pzer, New York City, USA
16Pzer, Mailand, Italien
17Pzer, Sandwich, United Kingdom
18Divisione di Oncologia Medica del Melanoma, Sarcoma e Tumori Rari, IEO
Istituto Europeo di Oncologia, Mailand, Italien
19Istituto Nazionale Tumori IRCCS Fondazione Pascale, Melanoma Unit, Cancer
Immunotherapy and Innovative Therapies, Neapel, Italien
Background: In the randomized, 2-part, multicenter, open-label, phase
3 COLUMBUS study, ENC + BIN (approved in the US, EU, and other
countries) and ENC mono improved PFS and OS rates vs VEM in patients
with BRAFV600-mutant metastatic melanoma. Here we report data from
the 7-year analysis of COLUMBUS part 1.
Methods: Pts with advanced or metastatic BRAFV600-mutant melanoma
were randomized 1:1:1 to ENC 450 mg QD + BIN 45 mg BID, VEM 960 mg
BID, or ENC 300 mg QD. Pts were treatment (tx)-naive or had progression
aer 1st-line immunotherapy (IO). No prior BRAF/MEKi was allowed.
Randomization was stratied by cancer stage (IIIB + IIIC + IVM1a +
IVM1b vs IVM1c), ECOG PS (0 vs 1), and prior 1st-line IO (yes vs no).
Result: 577 pts were randomized 1:1:1 to ENC + BIN, VEM, or ENC
mono. Updated analyses were conducted aer >93 mo of minimum fol-
low-up (cuto: Jan 13, 2023). e 7 year PFS and OS rates (95% CI) were
21.2% (14.7, 28.4) and 27.4% (21.2, 33.9) in the ENC + BIN arm and 6.4%
(2.1, 14.0) and 18.2% (12.8, 24.3) in the VEM arm, respectively. TEAEs
(≥30% with ENC + BIN) were nausea, diarrhea, vomiting, arthralgia, and
fatigue. Grade 3/4 TEAEs (≥5% with ENC + BIN) were γ-glutamyltrans-
ferase increased, blood CPK increased, hypertension, ALT increased, and
anemia. Across arms, 16% to 20% of pts discontinued tx due to AEs. Aer
tx discontinuation, 15% of pts from the ENC + BIN arm, 42% from the
VEM arm, and 28% from the ENC mono arm received BRAF/MEKi tx;
42% from the ENC + BIN arm, 49% from the VEM arm, and 43% from
the ENC mono arm received checkpoint inhibitors.
Discussion: e combination ENC + BIN showed a cnsiderably higher
PFS rate and a trend towards higher OS rate than VEM.
Conclusion: With a median duration of follow-up of 100 mo, the 7-year
analysis from COLUMBUS part 1 conrms the long-term, sustained e-
cacy and known safety prole of ENC + BIN, with no new safety signals
emerging, in pts with BRAFV600-mutant metastatic melanoma.
Clinical Trial identication: NCT01909453
Previously presented at ESMO 2023, FPN (Final Publication Number): 1113P, Dirk
Schadendorf et al. - Reused with permission
Disclosure Statement: e authors declare no conict of interest.
417
Transanal total mesorectal excision: short and long-term
results of four certied colorectal cancer centers in Germany
Elena Grundler1; Michael Gerken2; Sabine Schatz3; Luca Dittrich4;
MatthiasBiebl4; Andreas Rink5; Vinzenz Völkel2; Alois Fürst3
1Universität Regensburg, Regensburg, Deutschland
2Universität Regensburg, Tumor Center Regensburg - Centre for Quality
Management and Health Services Research, University of Regensburg,
Regensburg, Deutschland
3Caritas-Krankenhaus St. Josef, Regensburg, Deutschland
4Charité Universitätsmedizin Berlin, Klinik für Allgemein- und Viszeralchirurgie,
Hindenburgdamm 30, Berlin, Deutschland
5Universitätsklinikum Essen (AöR) Klinik für Allgemein-, Viszeral- und
Transplantationschirurgie, Essen, Deutschland
Background: Transanal total mesorectal excision (TaTME) is consid-
ered a promising innovation in the treatment of low rectal cancer (1,2).
However, in some countries there exist concerns about oncologic safety, as
TaTME was not associated with benecial results in some studies (3). is
study aims to determine the long term oncologic outcome aer TaTME
surgery in Germany.
Methods: Data from patients who had undergone elective TaTME sur-
gery in four certied colorectal cancer centers in Germany between 2014
and 2021 were analyzed. e primary endpoint was the 3-year local recur-
rence rate and local recurrence free survival (LRFS). Secondary outcomes
included overall survival (OAS), operation time, completeness of local
tumor resection, lymph node resection, and postoperative complications.
Result: A total of 378 patients were analyzed. e majority was male
(n=272, 71.9%) and the mean age was 61.6 years. e mean operating time
was 264 minutes. Locally complete resection was achieved in 96.3% of the
cases; in 87.3% of the cases, twelve or more lymph nodes were harvested.
At a median follow up time of 2.5 years a local recurrence event occurred
in 8 of 326 patients without distant metastases (2.5%). is resulted in
a 3-year cumulative local recurrence rate of 2.2% and a 3-year LRFS of
88.1%. e 3-year overall survival rate was 88.9%.
Discussion: e surgeons of all four participating clinics completed train-
ing courses for TaTME. erefore, our results might not be transferable to
settings with inexperienced surgeons and low volume centers.
Conclusion: TaTME is suitable for overcoming the anatomical and tech-
nical challenges of surgery for low and very low rectum tumors and is
associated with favorable short and long-term outcomes. However, su-
cient skills and experience are mandatory prerequisites to safely integrate
the technique into surgical routine care.
Indication of source:
1. Lacy FB et al., BMC Cancer 2020.
2. Hol JC et al.,Tech Coloproctol 2019.
3. Larsen SG et al., Br J Surg 2019.
Disclosure Statement: e authors declare no conict of interest.
428
Defeated and yet not quite over - long-term memories
ofcancer
Vinzenz Völkel1; Brunhilde Steinger1; Michael Koller2;
MonikaKlinkhammer-Schalke1; Patricia Lindberg-Scharf1
1Tumour Centre Regensburg, Centre of Quality Management and Health
Services Research, University of Regensburg, Regensburg, Deutschland
2Centre for Clinical Studies, University Hospital Regensburg, Regensburg,
Deutschland
Background: anks to medical progress the number of long-term survi-
vors of colorectal cancer continues to increase. is study aimed to inves-
tigate the memories of colorectal cancer patients about their disease and
treatment experiences up to seven years aer their participation in a RCT
for direct improvement of quality of life (RCT DIQOL, 1).
Methods: A questionnaire asked colorectal cancer survivors about their
worst experiences as well as positive aspects related to the disease and
advice they would give to newly diagnosed patients. Patient* responses
were categorized and analyzed quantitatively.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts56
Result: Of 146 survivors who originally participated in the RCT DIQOL, 96
(66%) returned the questionnaire a mean of 78.3 months aer starting their
therapy. e majority (33%) of the worst experience statements related to
psychological distress,” followed by “indigestion and discomfort with bowel
movements” (17%) and “cancer diagnosis” (16%). Of survivors with a history
of stoma, the majority (36%) described “the stoma” as their worst experience.
At 45%, “change in life priorities” was the most common positive category,
followed by “support from doctors/nurses” (25%). 43% of survivors consid-
ered “ghting spirit” the most important advice for coping with the disease.
Discussion: Comparable to the results of a previous study on breast cancer
survivors, “psychological distress,” “change in life priorities,” and “ghting
spirit” emerged as prominent concepts. In addition, some entity-specic
issues, such as the impact of a stoma, are of particular importance for
colorectal cancer survivors.
Conclusion: By communicating their memories, long-term survivors
actively shape the public perception of colorectal cancer and thus also inu-
ence future patients. ese ndings may serve as the basis for programs to
improve patient- and quality-of-life-centered follow-up of tumor patients.
Indication of source:
1 Klinkhammer-Schalke et al., Eur J Cancer.
Disclosure Statement: e authors declare no conict of interest.
439
Impact of laparoscopic versus open surgery on cellular
immunity in colorectal cancer patients: a systematic review
and meta-analysis
Annika Bohne1; Elena Grundler1; Helge Knüttel2; Alois Fürst3; VinzenzVölkel4
1Universität Regensburg, Regensburg, Deutschland
2Universitätsbibliothek Regensburg, Regensburg, Deutschland
3Caritas-Krankenhaus St. Josef, Klinik für Allgemein-, Viszeral-, Thoraxchirurgie
und Adipositasmedizin, Regensburg, Deutschland
4Tumorzentrum Regensburg, Zentrum für Qualitätssicherung und
Versorgungsforschung der Universität Regensburg, Regensburg, Deutschland
Background: Laparoscopic surgery (LS) is hypothesized to result in a
milder surgical stress response, which may contribute to the observed
clinical benets aer LS. erefore, the cellular response aer laparo-
scopic (LS) and open (OS) colorectal cancer (CRC) resections was evalu-
ated in a comprehensive systematic review and meta-analysis.
Methods: MEDLINE, Embase, Web of Science (SCI-EXPANDED), the
Cochrane Library, Google Scholar, ClinicalTrials.gov, and ICTRP were
systematically searched for randomized controlled trials (RCTs) compar-
ing cellular immunity in CRC patients of any stage between LS andOS.
A narrative synthesis and random eects-weighted inverse variance
meta-analysis was performed. e RoB2 tool was used to assess the risk of
bias (RoB). e meta-analysis was prospectively registered in PROSPERO
(CRD42021264324).
Result: A total of 14 RCTs including 974 participants were assessed.
Narrative synthesis showed higher NK cell lytic activity and HLA-DR II
expression rates, higher NK cell numbers, CD3+, CD4+ and CD8+ T-cell
counts, a higher CD4+/CD8+ ratio and lower WBCs aer LS in overall
eight trials. e meta-analyses yielded signicantly higher NK cell counts
aer LS at postoperative day (POD)4 (mean dierence (MD) 30.80 cells/
µL [19.68; 41.92],p <0.00001) and POD6–8 (MD 45.08 cells/µL [35.95;
54.21],p <0.00001). RoB was low in ve, of some concerns in seven, and
high in two studies. Except for a lower WBC aer OS in one trial, no nar-
rative or quantitative analysis favoured the OS group.
Discussion: e narrative synthesis generally showed more favourable
outcomes aer LS, being supported by the signicantly higher NK cell
counts seen in the meta-analysis. Main limitations of analyses were small
sample sizes and a heterogenous set of parameters and measuring time-
points of included RCTs.
Conclusion: Although further research is required, the laparoscopic
approach is possibly associated with lower inammation and better pres-
ervation of cellular immunity compared to OS.
Disclosure Statement: e authors declare no conict of interest.
502
FRESCO-2: A global phase 3 multiregional clinical trial (MRCT)
evaluating the ecacy and safety of fruquintinib in patients
(pts) with refractory metastatic colorectal cancer (mCRC)
Dirk Arnold1; Arvind Dasari2; Sara Lonardi3; Rocio Garcia-Carbonero4;
Maria Elena Elez Fernandez5; Takayuki Yoshino6; Alberto F. Sobrero7;
James C. Yao2; Pilar García Alfonso8; Judit Kocsis9; Antonio Cubillo
Gracian10; Andrea Satore-Bianchi11; Taroh Satoh12; Violaine Randrian13;
Jiri Tomasek14; Georey Chong15; Zhao Yang16; William Shelman16;
Marek Kania16; Josep Tabernero5; Cathy Eng17
1Asklepios Tumorzentrum Hamburg, Department of Oncology and Hematology,
AK Altona, Hamburg, Deutschland
2Department of Gastrointestinal Medical Oncology, The University of Texas MD
Anderson Cancer Center, Houston, TX, USA
3Medical Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS Padua,
Padua, Italien
4Oncology Department, Hospital Universitario 12 de Octubre, lmas 12, UCM,
Madrid, Spanien
5Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Institute of Oncology,
Barcelona, Spanien
6Department of Gastroenterology and Gastrointestinal Oncology, National
Cancer Center Hospital East, Kashiwa, Chiba, Japan
7Department of Medical Oncology, Azienda Ospedaliera San Martino, Genoa,
Italien
8Medical Oncology, Hospital Universitario Gregorio Marañón, Madrid, Spanien
9Department of Oncoradiology, Bács-Kiskun Megyei Oktatókórház, Kecskemét,
Ungarn
10Medical Oncology, Hospital Universitario Madrid Sanchinarro Centro Integral
Oncológico Clara Campal, Madrid, Spanien
11Department of Oncology and Hemato-Oncology, Università degli Studi di
Milano, Milan, Italien
12Department of Gastroenterological Surgery, Graduate School of Medicine,
Osaka University, Suita, Japan
13Hepato-Gastroenterology Department, Poitiers University Hospital, Poitiers,
Frankreich
14Department of Complex Oncology Care, Masaryk Memorial Cancer Institute,
Brno, Tschechische Republik
15Olivia Newton John Cancer & Wellness Centre, Austin Hospital, Heidelberg,
VIC, Australien
16HUTCHMED, Florham Park, NJ, USA
17Department of Medicine, Division of Hematology and Oncology, Vanderbilt
Ingram Cancer Center, Nashville, TN, USA
Background: Eective treatment options are limited for pts with refrac-
tory mCRC. Fruquintinib (F), a highly selective, potent, oral tyrosine
kinase inhibitor of VEGFR-1, -2 and -3, was approved in China in the
3L+ mCRC setting based on results from FRESCO (NCT02314819).
FRESCO-2 (NCT04322539) evaluated F in more heavily pretreated pts
reecting current global practices.
Methods: FRESCO-2 was a randomized, double-blind, placebo
(P)-controlled, phase 3 MRCT conducted in the US, Europe, Japan, &
Australia, comparing F + best supportive care (BSC) with P + BSC. Pts
were randomized 2:1 to F 5 mg PO or P, QD, 3 wks on, 1 wk o, in 28-d
cycles. Key criteria: prior chemotherapy, anti-VEGF therapy and, if RAS
wild type, anti-EGFR therapy; if BRAFV600E mutant or MSI-H, a targeted
regimen; & prior exposure to triuridine/tipiracil and/or regorafenib.
Primary endpoint: overall survival (OS); key secondary endpoints: pro-
gression-free survival (PFS), objective response rate (ORR), disease
control rate (DCR), and safety. Final analysis was aer 480 OS events.
Results: From Aug 14, 2020–Dec 2, 2021, 691 pts were randomized (F:461
vs P:230; Europe n=495; F:329 vs P:166; Germany n=19; F:8 vs P:11; data-
cut: Jun 24, 2022). Baseline characteristics were balanced. F signicantly
improved OS overall (median 7.4 months [m] vs 4.8 m P; HR 0.66 [95%
CI 0.55–0.80]; p<0.001) and in European pts (median 7.6 m vs 4.6 m P;
HR 0.69 [95% CI 0.55–0.86]; p<0.001); and PFS overall (median 3.7 m
vs 1.8 m P; HR 0.32 [95% CI 0.27–0.39]; p<0.001) and in European pts
(median 3.7 m vs 1.9 m P; HR 0.32 [95% CI 0.26–0.40]; p<0.001). Median
follow-up was 11.3 m F vs 11.2 m P. Subsequent anticancer therapies were
29.4% F vs 34.3% P. DCR was 55.5% F vs 16.1% P and ORR was 1.5% F vs
0 P. Grade ≥3 adverse events were 62.7% F vs 50.4% P.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 57
Discussion: F had a signicant and clinically meaningful improvement
in OS vs P in pts with refractory mCRC. F was well tolerated with a
safety prole consistent with the established prole for F monotherapy.
Conclusion: FRESCO-2 results are consistent with FRESCO and should
support a new treatment option in refractory mCRC.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
542
Left hepatic lobe within an epigastric hernia associated to
liver metastasis
Conrad-Jakob Schiner1; Roland Croner2; Frank Meyer2
1Dept. of Trauma Surgery, University Hospital, Magdeburg, Deutschland
2Dept. of General, Abdominal, Vascular and Transplant Surgery; University
Hospital, Magdeburg, Deutschland
Background: Aim: An extraordinary hernia nding (le liver & intestine
within the hernia sac) is illustrated as teaching case example.
Methods: Scientic “Case report”.
Result (Case presentation): Medical history (hx): Enlarging so bulging
of the upper abdomen with no local pain (own: le hemicolectomy for
cancer [Ca] of the decending colon [pT3b pN0 {0/22} L0 V0 cM0]). Aer
2 re-laparotomies because of an anastomotic insuciency, transversos-
toma was created, which was never excided for re-establishing the GI
Passage since the patient did not agree.
Clinical nding: Male patient of middle age with previous median laparot-
omy cut (aer surgical intervention for colon Ca) with a palpable epigas-
tric fascia gap of appr. 12×20 cm (width × length - hepatic margin within
the hernia sac (Diagnosis).
Diagnostics: - In 2020, follow-up CT scan revealed hepatic tumor lesions
(secondary nding: incisional hernia w/ le lobe & intestine within the
hernia sac).
CT-guided puncture of the hepatic tumor (Tu) lesions showed metas-
tases of the moderately dierenciated adeno-CA of the colon.
Molecular genetics revealed KRAS-mutation, NRAS-wild type,
MMRp status.
erapy: Radiation & one cycle of FOLFOX-based chemotherapy regimen
were initiated resulting in increasing size of Tu lesions. Subsequently, ther-
apy was aborted due to a liver abscess. In 9/2020, “atypical right hemi-
hepatectomy” (resection of the segments V-VII & one third of VIII) incl.
Vicryl mesh implantation (“onlay” position) for laparotomy closure was
performed.
Outcome/follow-up investigation: e patient has been Tu-free since
X/2020 - due to his medical hx, the patient resigned stoma excision &
sucient hernia repair with a mesh.
Conclusion: e liver can be considered an unusual hernia content of an
incisional hernia in the spectrum of rare hernia ndings (e.g., Tu lesions
of peritoneal carcinomatosis within an inguinal hernia sac etc.).
Disclosure Statement: e authors declare no conict of interest.
559
NOTCH Pathway Inhibition Increases Radiosensitivity in a
Context-Dependent Manner
Hannah Flebbe; Melanie Spitzner; Carolin Schneider; Lukas Krauß;
Michael Ghadimi; Günter Schneider; Marian Grade
Universitätsmedizin Göttingen, Göttingen, Deutschland
Background: Preoperative chemoradiotherapy followed by surgical
resection represents a standard treatment for locally advanced rectal can-
cer. We recently demonstrated that activation of the NOTCH signaling
pathway increases treatment resistance (1). In the present study, our aim
was to evaluate the eect of inhibitors of the NOTCH-signaling pathway
on radiosensitivity.
Methods: Two rectal cancer cell lines with dierent modes of NOTCH
activation were treated with LY3039478, a y-secretase-inhibitor, and with
RIN1, which targets RBPJ, the key downstream transcription factor of the
NOTCH pathway. Subsequently, colony formation, cell cycle analysis and
RNA-seq was performed.
Result: e eects of NOTCH pathway inhibition were dierent between
SW837 and SW1463. While treatment with 5 µM LY3039478 resulted in
sensitization of SW837, but not SW1463, 2.5 µM RIN1 increased sensitiv-
ity to chemoradiotherapy in both cell lines. RIN1 induced a G2-arrest 24
hours aer irradiation in SW837, while there was a signicant decrease
of cells in the G1-phase aer treatment with RIN1 in SW1463. To dene
pathways regulated by the NOTCH pathway inhibitors, RNA-seq data
were analyzed. Interestingly, substantially more genes were signicantly
up- or downregulated in SW1463 compared to SW837 with only mini-
mally overlapping genes. Interestingly, however, GSEA analysis revealed
that similar pathways were deregulated in both cell lines.
Discussion and Conclusion: We demonstrated that inhibitors of the
NOTCH signaling pathway may play a role in sensitizing rectal cancer to
irradiation therapy, and should be further evaluated.
Indication of source:
1 Koerdel K, et al. NOTCH Activation via gp130/STAT3 Signaling Confers
Resistance to Chemoradiotherapy. Cancers (Basel). 2021 Jan 26;13(3):455.
doi: 10.3390/cancers13030455. PMID: 33530306; PMCID: PMC7865718.
Disclosure Statement: e authors declare no conict of interest.
585
More ecient use of colonoscopy-based colorectal cancer
screening by low-barrier, low-threshold pretesting
Thomas Heißer; Rafael Cardoso; Tobias Niedermaier;
Michael Homeister; Hermann Brenner
Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
Background: ‘Gateopener’ colonoscopy-based screening is an innovative
concept to better target colonoscopy to those who are most likely to bene-
t from it. It combines invitations to screening colonoscopy with the oer
of pretesting with a single ‘gateopener’ fecal immunochemical test (FIT)
which is applied with a lower positivity threshold than in conventional
screening. We explored optimized use of this approach for reducing CRC
incidence and mortality.
Methods: Using COSIMO, a previously validated simulation tool, we
compared outcomes of gateopener screening to those of conventional
FIT- or colonoscopy-based screening strategies. Gateopener screen-
ing was modelled using SENTiFIT-FOB Gold (Sentinel Diagnostics) as
exemplary ‘gateopener’ FIT. We assessed various low hemoglobin cut-os
(10,8,6,4, and 3 µg/g feces).
Result: Gateopener screening at cut-os of 6, 4 or 3 µg/g outperformed
conventional screening colonoscopy in terms of CRC incidence reduc-
tion, with 16-25%, 50-57% and 66-72% more prevented cases, respectively,
aer ten years. All gateopener scenarios signicantly increased prevented
deaths, at low cut-os more than doubling the numbers achieved by con-
ventional screening colonoscopy. Compared to biennial FIT, gateopener
screening prevented 7-163% more CRC cases, with lower cut-os asso-
ciated with higher gains, and prevented approximately equal to signi-
cantly higher (12-21%) numbers of CRC deaths. Cut-os of 10 and 8 µg/g
required fewer colonoscopies per prevented case and death.
Conclusion: Gateopener screening outperforms conventional CRC
screening by oering considerably stronger reduction of CRC incidence
and mortality rates as well as considerably increased screening eective-
ness. e feasibility of the concept should be assessed by a pilot study in
real-life practice.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts58
657
Integrin β6 mediates binding of disseminated colorectal
cancer cells to endothelial cell
Chiara Van Passen1; Julia Krug2; Luisa Weiss1; René Krüger1; Mariam
Mohammed Abdou1; Philipp Busenhart3; Michael Scharl4; Elisabeth
Naschberger1; Michael Stürzl1
1Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen,
Division of Molecular and Experimental Surgery, Erlangen, Deutschland
2Universitätsklinikum Würzburg, Dermatology Department, Würzburg,
Deutschland
3Recolony AG, Zurich, Schweiz
4Universitätsspital Zürich, Klinik für Gastroenterologie und Hepatologie, Zurich,
Schweiz
Background: Aggressive disease and poor prognosis in colorectal car-
cinoma (CRC) is associated with expression of integrin β6 (ITGB6).
Furthermore, ITGB6 regulates immune evasion through the activation
of latent TGF-β. In the present study, we examined the role of integrin
β6 expression in CRC tumor cells in the adhesion to endothelial cells, a
crucial step in metastasis.
Methods: Western Blot, CRISPR/Cas9 knockout, adhesion assay and
cultivation of cells under ow.
Results: HT29 cells were identied as an ITGB6 expressing cell line
and the ITGB6 expression was deleted using CRISPR/Cas9 technology.
Control HT29 cells expressing ITGB6 showed a signicantly increased
adhesion to TNF-α or IL-1β treated HUVEC as compared to HT29 with
an ITGB6 KO under static conditions. Remarkably, the increased adhe-
sion of ITGB6 expressing cells to cytokine activated HUVEC could be
conrmed under ow conditions to mimic the blood circulation. ese
results further supported a direct role for ITGB6 in the adhesion of tumor
cells to HUVEC. Interestingly, TNF-α-induced upregulation of ITGβ6
expression in the tumor cells resulted in increased adhesion. Moreover,
adhesion of ITGB6 expressing HT29 cells could be inhibited (i) by an
ITGαvβ6 blocking antibody and (ii) an RGD peptide.
Discussion: ese results indicate that direct binding of ITGB6 con-
tributes signicantly to the adhesion of CRC tumor cells to the vascular
endothelium. e potential interaction of ITGB6 with luminal bronectin
deposits in the liver blood vessels as a mechanism of increased adhesion
of ITGB6 expressing tumour cells is under investigation.
Conclusion: Tumor cells expressing ITGB6 provoke an increased interac-
tion with endothelial cells, indicating an important, novel role of ITGB6
in the metastatic process.
Indication of source:
1 Bengs S. et al. Int J Cancer. 2019.
2 Busenhart P. et al. J Immunother Cancer. 2022.
3 Barbazán J. et al. Cancer Res 2017.
Disclosure Statement: e authors declare the following: Philipp Busenhart is the
CBO and co-founder of Recolony.
682
Tackling the complexity of cancer therapy by combining
Optim.AI™ and PD3D® models
Ulrike Pfohl1; Masturah Mohd Abdul Rashid2; Jhin Jieh Lim2; Jürgen
Loskutov1; Lena Wedeken1; Edward Kai-Hue Chow3; Hugo Saavedra2;
Christoph Reinhard1,4; Christian Regenbrecht1,4,5
1Cellphenomics GmbH, Berlin, Deutschland
2KYAN Therapeutics, Singapore, Singapore
3Cancer Science Institute of Singapore, Singapore, Singapore
4ASC Oncology GmbH, Berlin, Deutschland
5Institut für Pathologie, Universitätsklinikum Göttingen, Göttingen,
Deutschland
Background: In a previous study, we have shown that patient-derived 3D
(PD3D®) models of colorectal cancer (CRC) are dierentially sensitive to
MEK inhibitors (1). However, given the numerous genomic aberrations
and tumor heterogeneity in CRC, patients may benet from combina-
torial therapies, particularly those who have inoperable or metastatic
tumors. In the present study, we investigated the feasibility of combining
two platforms, Optim.AI™ with PD3Ds, to identify more eective cancer
therapies.
Methods: CRC PD3Ds were tested with 155 dierent combinations of
12 drugs at variant concentrations. e post-treatment cell viability was
measured and used for Optim.AI™ analysis to evaluate and compare the
best therapies. Optim.AI™ is a hybrid computational-experimental plat-
form that uses small data sets to rationally converge to optimal drug com-
binations within a dened drug search space. By mapping experimental
data points to a second-order quadratic function, Optim.AI™ can predict
cell-killing ecacy for all other possible combinations.
Result: Optim.AI™ analysis revealed dierential drug sensitivity between
CRC PD3Ds. e top-ranked drug combinations consisted of SN-38
paired with MEK-inhibitors trametinib or cobimetinib.
Discussion: Based on our preliminary data, we found dierences in the
top-ranked MEK inhibitor-based drug combinations in CRC PD3Ds with
dierent mutation proles. If these results are combined with appropriate
biomarkers, patients’ stratication based on individual sensitivity proles
and treatment outcomes will be improved.
Conclusion: is study has successfully demonstrated the feasibility and
robustness of combining Optim.AI™ and PD3Ds in identifying eective
drug combination therapies, particularly in CRC. is combined tech-
nology provides precise insights into tumor treatability and its functional
causes of treatment outcomes, leading to new treatment combinations
and accelerating the development of new cancer drugs.
Reference:
1 U. Pfohl et al., Cancers. 14, 3252 (2022).
Disclosure Statement: e authors declare the following: CRAR is shareholder at
CELLphenomics GmbH, a company oering drug screens on organoid models,
and ASC Oncology GmbH, a company involved in patient specic therapy
prediction.
698
Comparison between intraoperative peripheral and
mesenteric blood sampling with blood collection from fresh
surgical colorectal specimens
Phillip Löhr1; Bianca Grosser2; Przemyslaw Grochowski2; Andreas Rank1;
Johanna Waidhauser1; Bruno Märkl2; Dmytro Vlasenko3
1Universitätsklinikum Augsburg, 2. Medizinische Klinik, Hämatologie und
Onkologie, Augsburg, Deutschland
2Universitätsklinikum Augsburg, Institut für Pathologie und molekulare
Diagnostik, Augsburg, Deutschland
3Universitätsklinikum Augsburg, Klinik für Allgemein-, Viszeral- und
Transplantationschirurgie, Augsburg, Deutschland
Background: Recently we showed that circulating lymphocytes reect
the local immune response in colorectal cancer. Due to an assumed dilu-
tion eect during blood circulation, we developed an approach to exploit
blood in fresh surgical specimens.
Methods: Blood is aspirated from the main vein of freshly received
colorectal specimens using a standard infusion Catheter. To compare the
results with in-vivo conditions, peripheral and mesenteric blood was col-
lected during surgery. In a rst attempt, four cases were analyzed using
ow cytometry. ELISA-tests for FABP4 and the detection of circulating
tumor cells are planned for further studies.
Result: Aspirating blood was successful in 4 of 4 cases. e volumes
of collected blood varied between 2 and 3 ml. Immune cell analyses of
the three modalities (peripheral – in-vivo mesenteric – ex-vivo mesen-
teric) revealed comparable results when B cells, NK cells, and CD8 pos-
itive T cells were analyzed. However, CD4 values showed slightly higher
cell counts, as well as a higher level of early activation (expressing more
CD69) when taken from ex vivo mesenteric blood vessels. Moreover, an
increasing tendency of early, naïve and regulatory CD4 cell counts and a
decreasing trend of intermediate CD4 cell populations could be observed
in blood taken from fresh specimens.
Discussion: e preliminary results of this study prove the feasibility of
in-vivo and ex-vivo mesenteric blood sampling. Nevertheless, further
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 59
studies are needed to determine the exact role of the cellular immune
system at the boundary between local and systemic response.
Conclusion: Blood from surgical GI specimens could oer the possibility
of an easy-to-access diagnostic compartment directly at the border between
local and systemic organism, and facilitates a more precise analysis of the cel-
lular immune response in surgically treated patients with colorectal cancer.
Disclosure Statement: e authors declare no conict of interest.
711
Phase II, single-arm, open-label study of dostarlimab
monotherapy in previously untreated patients with stage II/III
dMMR/MSI-H locally advanced rectal cancer: trial in progress
Andrea Cercek1; Jean-Baptiste Bachet2; Jaume Capdevilla3; Naureen
Starling4; Eric Chen5; Maria DI Bartolomeo6; Takayuki Yoshino7; Gordana
Vlahovic8; Eleftherios Zografos9; Sean O’donnell10; Zsolt Szijgyarto9;
Volker Heinemann11
1Division of Solid Tumor Oncology, Memorial Sloan Kettering Cancer Center,
New York, USA
2Sorbonne University, Pitié Salpêtrière Hospital, APHP, Frankreich
3Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology
(VHIO), Barcelona, Spanien
4The Royal Marsden Hospital, London, United Kingdom
5University Health Network, Toronto, Ontario, Kanada
6Fondazione IRCCS – Istituto Nazionale dei Tumori, Milan, Italien
7National Cancer Center Hospital East, Chiba, Japan
8GSK, MA, USA
9GSK, Stevenage, United Kingdom
10GSK, Collegeville, PA, USA
11Comprehensive Cancer Center Munich, LMU Klinikum Munich, Munich,
Deutschland
Background: In patients (pts) with locally advanced rectal cancer (RC),
organ-sparing non-operative management (NOM) following a clinical
complete response (cCR) to treatment (Tx) avoids the potential com-
plications and quality of life impact associated with surgery/chemoradi-
otherapy. Although neoadjuvant chemotherapy is standard Tx, pts with
mismatch repair decient (dMMR) tumors respond poorly. Ecacy of the
programmed death (PD)-1 inhibitor, dostarlimab in previously untreated
pts with locally advanced dMMR RC was evaluated in a Phase II study. All
12 pts who completed 6 months (mo) of Tx had cCR and received NOM,
with no Grade ≥3 adverse events reported [1]. AZUR-1 will evaluate the
ecacy and safety of dostarlimab in pts with previously untreated locally
advanced dMMR/microsatellite instability-high (MSI-H) RC.
Methods: AZUR-1 (NCT05723562) is a global, multicenter, single-arm,
open-label, Phase II study (target N= ~100). Key eligibility criteria: age
≥18 years, no prior radiation/systemic Tx/surgery for RC, ECOG 0–1, and
no tumor-caused symptomatic bowel obstruction. Pts must have a tumor
with dMMR status/MSI-H phenotype, determined locally/by central ref-
erence laboratory. Dostarlimab 500 mg will be administered intravenously
every 3 weeks for ≤9 cycles. Primary endpoint: cCR by independent cen-
tral review (ICR) at 12 mo, dened as achieving and maintaining cCR for
12 mo. Key secondary endpoints: cCR by ICR at 36 mo, 3-year event-free
survival by investigator assessment, 5-year disease-specic survival, and
5-year overall survival. Pts with cCR by end of Tx will be assessed every
4–6 mo for recurrent disease for 5 years (NOM). Ecacy and safety will
be assessed in all pts who received ≥1 dose of dostarlimab. For a range
of plausible observed cCR12 rates (60–95%) in the primary analyses,
the planned sample size of 100 pts will provide a Clopper–Pearson exact
binomial two-sided 95% condence interval with lower condence limit
within ~10% of the observed cCR12 rate. No interim analyses are planned.
Indication of source:
1. Cercek, A et al. NEJM 2022;386:2363–76.
Disclosure Statement: e authors declare the following: 1Global, AC
BioTech, Acobio,Advanced Accelerator Applications, Amgen, AstraZeneca,
Bayer, Biomunex, BMS, Boehringer Ingelheim, Carsgen, Celgene, Chugai
Pharmaceutical, Daichi, Daiichi Sankyo, Eisai, Eli Lilly Bangladesh, Eli Lilly
ailand, Esteve, Exelixis, FALCO Biosystems, Federal government employee
721
International study on the prevalence of malnutrition
in centralized care for colorectal cancer patients
Carl Meißner1,2; Svenja Tiegges3; Martin Broehl3; Ronny Otto2;
Karsten Ridwelski2,4
1MVZ „Im Altstadtquartier“ GmbH, Magdeburg, Deutschland
2An-Institut für Qualitätssicherung in der operativen Medizin gGmbH,
Magdeburg, Deutschland
3WissWerk Standort Köln, Köln, Deutschland
4Klinikum Magdeburg gGmbH, Klinik für Allgemein- und Viszeralchirurgie,
Magdeburg, Deutschland
Background: e subject of malnutrition is not even consistently
addressed in all clinics or colorectal cancer centers but it is required in the
survey form for colorectal centers. e objective of this multicenter study
was to determine the prevalence of malnutrition in colorectal cancer
centers. Another objective is to investigate possible consequences, such as
complications or length of stay.
Methods: Between 2019 and 2021, patients in colorectal cancer centers
were examined in the preoperative phase. In addition to questions about
patients’ state of health and nutrition, two validated screening forms
were used.
Result: Data records of 3,102 patients were evaluated. Approximately
one-third of patients in colorectal cancer centers suer from malnutrition
preoperatively. e length of stay in hospital and the rate of complications
were signicantly higher when malnutrition was identied. e average
length of stay of patients with complications was approximately twice as
long as the stay of patients who had no complications.
Discussion: Despite the increased prevalence of malnutrition, the most of
the patients were still being discharged to the post-hospitalization setting
without any nutrition therapy. In particular, interdisciplinary support as
well as cooperation in the outpatient sector may have a decisive inuence
on subsequent convalescence. Procedures providing nutrition medicine
and their implementation are explicitly described in the guidelines.
Conclusion: Approximately one in three to four patients with a colorec-
tal carcinoma has an increased risk of malnutrition. Malnutrition has a
signicant impact both on the rate of complications and the length of
stay and may therefore have a decisive inuence on the costs. e results
underscore the need for systematic screening and at the same time should
increase clinics awareness of the importance of establishing a nutrition
management policy.
Disclosure Statement: e authors declare the following: Frau Tiegges
und Herr Broehl sind Mitarbeiter im Wisswerk Köln.
798
Testing for DPYD-polymorphism in upper rectal cancers
(stages ≥II) treated with upfront surgery and FOLFOX – did we
miss something in the past?
Paula Liersch1,2, Sascha Dierks3, Reiner Andag3, Charlotte de Boer4,5,
Torsten Liersch4, Birgit Jünemann4, Andrea Hille6, Julie Schanz2,3
1Department of Preventive Dentistry, Periodontology and Cariology, Göttingen,
Deutschland
2Department of Haematology and Medical Oncology, Göttingen, Deutschland
3Department of Clinical Chemistry, Göttingen, Deutschland
4Department of General, Visceral and Pediatric Surgery, Göttingen, Deutschland
5Department of Internal Medicine, Kiel, Deutschland
6Department of Radiotherapy and Radiation Oncology, Göttingen, Deutschland
Background: In April 2020, the European Medicines Agency (EMA)
recommended testing for the most common DPD-mutations in patients
prior to application of 5-uorouracil (5-FU).
Purpose: Using cryopreserved blood samples of patients with upper
rectal cancers, DPYD-testing was performed to evaluate occult DPYD-
polymorphism and its impact on acute adverse events (AE) and prognosis.
Patients, Material and Methods: 75 participants (median age: 69 yrs,
f: 26, m: 49) of the GAST-05-phase-IIb-trial (ISRCTN35198481) had
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts60
been tested for wildtype (WT) DPYD*2A at staging. Upfront surgery was
performed with total (TME, n=34) or partial (PME, n=41) mesorectal
excision. Postoperatively, FOLFOX (4 cycles; FA: 400 mg/m², 5-FU: 2400
mg/m², OX: 100 mg/m²) was indicated for stages ≥II. Acute AEs had
to be recorded according to NCI-CTC-AE grading. Survival was calcu-
lated using the Kaplan-Meier method. DPYD-re-testing was performed
according to well-established methods blinded to the clinical data.
Results: DPYD re-testing revealed 100% WT for DPYD*2A, DPYD*13
and the polymorphism c.2846A>T. Interestingly, in 5 (10%) patients
receiving CTx a DPYD-Hap B3 status was detected. For 43 patients
treated with FOLFOX, CTx-adherence (from cycle 1 to 4) was 100.0%,
97.7%, 95.3% and 93.0%, respectively. For patients with DPYD-WT, dos-
ages of 5-FU and OX had been administered in 92.6% and 75.3%, and
for HapB3-patients in 68.8% and 55.0% of the target, respectively. In
total of 612 AEs (all grades) with 28.9% hematologic, 27.6% gastroin-
testinal, 17.3% neurologic and 0.5% cardiac events, AEs grade 3/4 had
occurred in 3.3%. During follow-up (95%CI: 62.1; 130.8 months), recur-
rences were diagnosed for DPYD-WT- and HapB3-patients in 36.8% and
80.0%, respectively. For WT patients, pairwise testing showed better DFS
(p=0.010), but not OS (p=0.296).
Conclusion: DPYD-re-testing in rectal cancer patients detected occult
HapB3 mutations, its impact remains unclear.
Discussion: Further results will be presented in detail.
Disclosure Statement: e authors declare no conict of interest.
814
The role of SCD1 in colorectal cancer progression and its
potential as a therapeutic target
Paulina Pittrich1; Josef Ecker2; Klaus-Peter Janssen1
1Klinikum Rechts der Isar, München, Deutschland
2ZIEL - Zentralinstitut für Ernährungs- und Lebensmittelforschung, Freising,
Deutschland
Background: Metabolic reprogramming including activation of lipogen-
esis has been established as a hallmark of solid cancer. We have shown
previously that the lipidome is specically altered in human colorectal
cancer, which correlates with prognosis. One key enzyme upregulated
in this context is the stearoyl-CoA-desaturase-1 (SCD1), which is not
expressed in healthy digestive epithelia. SCD1 is essential for the produc-
tion of monounsaturated fatty acids and crucially involved in cancer for-
mation. However, the molecular mechanisms leading to an upregulation
of SCD1 in the tumor context, and its involvement in carcinogenesis, are
still unclear.
Methods: SCD1 expression was quantied in 110 colorectal carcinoma
patient tissues by qPCR and immunoblot analysis. Patients from all tumor
stages including liver metastasis were analyzed. For in vitro analyses,
various cellular assays with SCD1-decient human colorectal cancer cell
lines HCT116 and DLD1 were performed, such as proliferation, migra-
tion and chorion allantois membrane assay (CAM).
Result: Compared to healthy colon mucosa, intratumoral mRNA and
protein expression of SCD1 was signicantly increased, whereas SCD1
expression in liver metastasis was signicantly decreased, compared to
the primary tumors, and to healthy liver parenchyma. SCD1-decient
HCT116 cells showed signicantly reduced cell proliferation and 2D cell
migration, compared to parental cells. e invasion capacity and angio-
genic potential of SCD1-decient clones was reduced compared to paren-
tal cells in a CAM assay.
Discussion: ese results indicate that SCD1 is essential for colorectal
cancer metabolism and therefore its survival and aggressiveness. Why its
expression is decreased in matching liver metastasis is a question which
needs to be further addressed.
Conclusion: SCD1 plays a major role in colorectal cancer, by increasing
cell proliferation under cell stress conditions. Increased SCD1 expression
correlates with higher metastasis rate and poorer outcome.
Disclosure Statement: e authors declare no conict of interest.
818
Phase 3 study of tucatinib, trastuzumab, and modied
FOLFOX6 as rst-line treatment in HER2+ metastatic
colorectal cancer (MOUNTAINEER-03, trial in progress)
Volker Heinemann1; Thierry André2; Tanios Bekaii-Saab3; Andrea Cercek4;
Yoshiaki Nakamura5; Kanwal Raghav6; Salvatore Siena7; John Strickler8;
Eric Van Cutsem9; David Adelberg10; Jorge Ramos11; Shan Yang11;
Takayuki Yoshino5; Josep Tabernero12
1Comprehensive Cancer Center at Ludwig Maximilian University of Munich,
Munich, Deutschland
2Sorbonne Université et INSERM ‘Instabilité des Microsatellites et Cancer,
Hôpital Saint Antoine, Paris, Frankreich
3Mayo Clinic, Scottsdale, AZ, USA
4Memorial Sloan Kettering Cancer Center, New York, NY, USA
5National Cancer Center Hospital Japan East, Kashiwa, Japan
6MD Anderson Cancer Center, Houston, TX, USA
7Grande Ospedale Metropolitano Niguarda and Università degli Studi di Milano,
Milan, Italien
8Duke University Medical Center, Durham, NC, USA
9University Hospital Gasthuisberg and University of Leuven, Leuven, Belgien
10Merck & Co., Inc., Kenilworth, NJ, USA
11Seagen Inc., Bothell, WA, USA
12Vall D’Hebron University Hospital and Institute of Oncology (VHIO), Barcelona,
Spanien
Background: Current standard of care (SOC) for treatment of metastatic
colorectal cancer (mCRC) is multi-agent chemotherapy, +/- a VEGF or
EGFR inhibitor. HER2 amplication occurs in 3%-5% of mCRC patients
(pts), and ~5-14% of pts with RAS/BRAF wild-type (WT) mCRC tumors.
Tucatinib (TUC), a highly selective, HER2-directed tyrosine kinase inhib-
itor, is approved in multiple regions for HER2+ metastatic breast cancer
and is being investigated in gastrointestinal cancers. MOUNTAINEER
(NCT03043313) evaluated safety and ecacy of TUC and trastu-
zumab (T) in pts with treatment-refractory RAS WT HER2+ mCRC.
Results from the primary analysis showed clinically meaningful activ-
ity (conrmed objective response rate of 38.1% and median duration of
response of 12.4 months) and demonstrated TUC + T was well tolerated.
MOUNTAINEER-03 will investigate TUC plus modied FOLFOX6 + T
in pts with RAS WT, HER2+ mCRC.
Methods: MOUNTAINEER-03 (NCT05253651) is a global, open- label,
randomized, phase 3 study for rst-line treatment of HER2+ and RAS
WT locally advanced/unresectable or mCRC. ~400 adult pts will be
randomized 1:1 to TUC experimental arm (TUC [300 mg PO BID] + T
+ modied FOLFOX6) or the SOC arm (modied FOLFOX6 alone or
in combination with either bevacizumab or cetuximab).HER2 status is
determined centrally with tissue-based HER2 immunohistochemistry
and in situ hybridization. Pts may have received maximum 2 doses of
mFOLFOX6 in locally advanced/unresectable or metastatic setting prior
to randomization and may have received adjuvant treatment if completed
>6 months prior to enrollment. Randomization is stratied by primary
tumor location (le-sided vs other), liver metastases and number of doses
of mFOLFOX6 chemotherapy prior to randomization. Primary endpoint
is progression-free survival. Key secondary endpoints are overall survival
and conrmed objective response rate. Enrollment is ongoing in Europe,
and all other regions.
is abstract was previously presented at ESMO 2022, Final Publication Number:
1037, by ierry Andre (reused with permission).
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 61
852
A novel approach to enhance FOLFOX therapy in colorectal
cancer: combination of FASN inhibition and chemotherapeutic
agents
Fabian Beck1; Klaus-Peter Janssen1; Josef Ecker2
1Klinkum rechts der Isar, München, Deutschland
2Technische Universität München, München, Deutschland
Background: Altered lipid metabolism is noted in lots of tumor entities,
e.g. colorectal cancer (CRC). Fatty Acid Synthase (FASN) is one of the key
enzymes of lipid synthesis and is oen upregulated in CRC. is suggests
its inhibition as a target for chemotherapy, e.g. with a typical inhibitor
Cerulenin. Another FASN-Inhibitor, TVB-2640, is already undergoing a
clinical trial for breast cancer (Phase II) and CRC (Phase I). However, the
common treatment concept for CRC has not changed yet. e standard
FOLFOX scheme for CRC contains the chemotherapeutics Oxaliplatin
and 5-Fluoruracil (5ʹFU). erefore, this project aims to combine FASN-
Inhibition and FOLFOX to signicantly increase the eciency in colorec-
tal cancer.
Methods: To unravel this hypothesis, CRC cell lines and patient-derived
tumor and normal mucosa organoids, isolated aer surgery from pri-
mary tissue, were treated with FASN-Inhibitors, Oxaliplatin and 5ʹFU.
Metabolic and apoptosis marker were analyzed based on gene and protein
level, as well as by Sytox/Höchst immunouorescence staining.
Result: Preliminary results show that Cerulenin enhances the eect of
5ʹFU and Oxaliplatin in established CRC cell lines and patient-derived
organoids. Additionally, the analysis of treated HCT116 revealed that
standard chemotherapeutics induce a higher metabolic change than
Cerulenin.
Discussion: e increase in cell death of the organoids by addition of
Cerulenin to standard chemotherapeutics indicates that the combination
treatment could open a window for an addition to the reliable FOLFOX
treatment scheme.
Conclusion: However, many open questions regarding the combina-
tion of FASN-Inhibition, Oxaliplatin and 5`FU remain unanswered. An
optimized duration and concentration need to be determined as well as
the safety aspect on normal tissue has to be considered. To understand
the mechanism of action, pathway analysis will be included in future
experiments.
Disclosure Statement: e authors declare no conict of interest.
865
The role of NOTCH-signaling in mediating therapy resistance
in rectal cancer
Melanie Spitzner1; Alena Siebert1; Gizem Chelik2; Michael Ghadimi1;
Günter Schneider1; Jürgen Wienands2; Marian Grade1
1Department of General, Visceral and Pediatric Surgery, UMG, Göttingen,
Deutschland
2Institute of Cellular and Molecular Immunology, UMG, Göttingen, Deutschland
Background: Rectal cancer is associated with high morbidity and mortal-
ity rates aecting both men and women worldwide. In this context, resis-
tance to chemoradiotherapy (CRT) remains a major clinical dilemma.
erefore, it is important to uncover the molecular mechanisms under-
lying CRT resistance in rectal cancer in order to identify personalized
treatment strategies.
Methods: Gene expression levels of selected NOTCH pathway compo-
nents was obtained from microarray data of 207 rectal cancer patients,
treated with preoperative CRT, and correlated with their respective clini-
cal data. e relevance of NOTCH protein expression was further evalu-
ated in two rectal cancer cell lines (SW837, SW1463) and one colon cancer
cell line (LS411N) by Western blotting. Aer inhibition of the individual
NOTCH isoforms by RNAi technique, these cell lines were subjected to
colony formation assays in the absence or presence of CRT, which is the
standard assay in the eld to monitor treatment sensitivity.
Result: e microarray data underlined the intrinsic gene expression
heterogeneity in patients regarding their NOTCH prole. e NOTCH-
signature was associated with clinical outcome: Patients with a NOTCH-
low signature (n=52) showed a favorable disease-free survival (DFS)
compared to those with a NOTCH-high signature (n=155). In vitro, we
tested the NOTCH-negative cell line LS411N and the NOTCH-positive
cell lines SW837 and SW1463. CRT-resistant SW837 and SW1463 rectal
cancer cells showed increased sensitivity to therapy following the down-
regulation of individual NOTCH isoforms.
Discussion and Conclusions: Overall, these data demonstrate that high
levels of NOTCH receptors are associated with treatment resistance and
impaired disease-free survival. erefore, if further validated, inhibition
of NOTCH signaling may represent an alternative treatment option.
Disclosure Statement: e authors declare no conict of interest.
892
A contemporary assessment of total neoadjuvant therapy
(TNT) protocols for locally advanced rectal cancer: adoption
and expert perspectives at German Cancer Society (DKG)
certied colorectal cancer centers
Melanie C. Langheinrich1; Christoph Paasch2; René Mantke2; Klaus Weber3;
Stefan Benz4; Stephan Kersting1
1Universitätsmedizin Greifswald, Greifswald, Deutschland
2Universitätsklinikum Brandenburg an der Havel, Brandenburg, Deutschland
3Universitätsklinikum Erlangen, Erlangen, Deutschland
4Klinikverbund Südwest, Böblingen, Deutschland
Background: e approach to treating locally advanced rectal cancer
(LARC) has remarkably evolved. Total neoadjuvant therapy (TNT) is a
novel concept, which administered systemic chemotherapy in the neoad-
juvant setting, before or aer chemoradiotherapy (CRT) or short course
radiotherapy (SCRT).
Methods: A comprehensive online questionnaire, constituted of 14 TNT
queries targeting patients with LARC, was conducted among DKG certi-
ed colorectal cancer centers registered within the database of the Addz
(Arbeitsgemeinscha Deutscher Darmzentren) between December 2022
and January 2023.
Result: A third of the centers participated in patient enrollment for a TNT
study, 84% of centers reported treating patients in an analogous manner.
e decision to adopt a TNT approach was inuenced by factors such
as: lower third of the rectum, cT4 stage, and a positive circumferential
resection margin. Furthermore, there appears to be uncertainty in regard
to a clinical complete response (cCR) and the “Watch and Wait” (W&W)
approach. Some centers adopt the watch-and-wait approach (42%), others
only utilize it when extirpation is otherwise necessary (39%), and a por-
tion still proceed with surgery as initially planned (19%).
Discussion: Our ndings reveal that TNT is already being implemented
in clinical practice. Remarkably, TNT is mostly being performed out-
side of clinical trials. e survey also addressed the W&W approach in
the context of handling patients who achieve cCR. e ndings clearly
demonstrated diering perspectives and a lack of consensus on this
approach among the respondents.
Conclusion: is study presents an overview of current clinical practice
within DKG certied German colorectal cancer centers. It is noteworthy
that TNT is predominantly performed outside of clinical trials. Across
the centers there is signicant heterogeneity in handling clinical complete
response and adopting the W&W approach. Further research is needed
to establish standardization in the care of locally advanced rectal cancer.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts62
897
Adherence and acute toxicities in total neoadjuvant treatment
(TNT) of locally advanced rectal cancer (LARC)
Timotheus Ritter-Vanoorop1; Jana Nele Leoni Vanoorop1;
Andreas Leha2; Johanna Kreutzer1; Heiko Sülberg3; Philipp Schüler1;
Torsten Liersch1
1Klinik für Allgemein-, Viszeral- und Kinderchirurgie - Universitätsmedizin
Göttingen, Göttingen, Deutschland
2Institut für Medizinische Statistik - Universitätsmedizin Göttingen, Göttingen,
Deutschland
3X-act Cologne Clinical Research GmbH, Köln, Deutschland
Background: Adjuvant chemotherapy (CTx) aer neoadjuvant chemora-
diation (CRT) and total mesorectal excision (TME) in patients with LARC
is associated with high rates of CTx-non-performance, acute adverse
events (AE), dose reductions or treatment disruption. In part to increase
adherence to CTx, ongoing trials are using total neoadjuvant treatment
(TNT) upfront TME.
Methods: In this single center analysis, LARC patients treated
according to the multicenter TransValid-B-phase-I/II-trial (WHO-
UTN-U1111-1132-0235) were included. TNT was performed with
irradiation (28x1.8 Gy; in total 50.4 Gy) and concomitant infusion of
5-uorouracil (5-FU; 250 mg/m2/d, d1 - d14 and d22 - d35) and oxal-
iplatin (OX; 50 mg/m2 on d1, d8, d22 and d29). 4 weeks later, 3 cycles
FOLFOX were applied with OX (80-100 mg/m2), folinic acid (400 mg/m2)
and 5-FU (2400 mg/m2, civ over 46h) on d1, d15 and d30. TME was per-
formed 5 weeks later. Acute toxicities were recorded separately for each
TNT-modul according to NCI-CTC-AE criteria.
Result: 38 patients (7 f, 31 m, median age 63 years) with LARC (< 12 cm
from anal verge), stages III / IV in 92.1% and 7.9%, were assessed. During
CRT, total planned dose was applied in 97.4% (RT) and 94.7% (CTx).
Acute toxicity of grade ≥ 3 was reported in 26.3%, mainly as proctitis,
OX-associated neuropathy, diarrhea and dermatitis. Planned dose of
FOLFOX-CTx could be administered in 83.3%; all patients received
≥ 75% of the planned dose. During CTx, AEs (grade ≥ 3) were recorded in
13.9%. In particular, neuropathy (OX) and leukopenia (5-FU) were noted.
No patient discontinued CTx. AEs (grade ≥ 3) occurred in 35.3% aer
TME surgery (14.7% anastomotic leaks, 11.8% bladder voiding disorders).
A more detailed breakdown of the range of toxicities and the reasons for
dose reductions will be presented at DKK 2024.
Discussion: NeoCTx as part of TNT is safe and feasible; it is associated
with higher adherence and lower toxicity compared to conventional
adCTx as applied in larger clinical trials, the backbone of treatment
guidelines.
Conclusion: In multimodal treatment of LARC, neoCTx should be
preferred.
Disclosure Statement: e authors declare no conict of interest.
902
Multimodal treatment (MMT) in locally advanced rectal
cancers (LARCs): do acute surgical complications have an
impact on long-term survival?
Jana Nele Leoni Vanoorop1; Timotheus Ritter-Vanoorop1;
Johannes Martens1; Johanna Kreutzer1; Andreas Leha2; Heiko Sülberg3;
Torsten Liersch1
1Klinik für Allgemein-, Viszeral- und Kinderchirurgie - Universitätsmedizin
Göttingen, Göttingen, Deutschland
2Institut für Medizinische Statistik - Universitätsmedizin Göttingen, Göttingen,
Deutschland
3X-act Cologne Clinical Research GmbH, Köln, Deutschland
Background: Ongoing trials prefer total neoadjuvant treatment (TNT)
instead of standard chemoradiation (CRT) followed by total mesorectal
excision (TME) and adjuvant chemotherapy (CTx) for LARC to increase
pCR-rates, survival and MMT adherence. Due to this, what is the impact
of intensied neoadjuvant therapy on acute toxicities?
Methods: In these analyses, monocentric patients of the TransValid-A-
(NCT03034473; Arm A) and -B-phase-I/II-trial (WHO-UTN-U1111-
1132-0235; Arm B) were included. Standard treatment (Arm A) was
performed with 5-FU-based CRT, followed by TME and 5-FU- or FOLFOX-
CTx. TNT (Arm B) was performed with irradiation (28x1.8 Gy; in total
50.4 Gy) and concomitant infusion of 5-FU (250 mg/m2/d, d1 - d14 and
d22 - d35) and oxaliplatin (OX; 50 mg/m2 on d1, d8, d22 and d29). 4 weeks
later, 3 cycles FOLFOX were applied with OX (80-100 mg/m2), folinic acid
(400mg/m2) and 5-FU (2400 mg/m2, civ over 46h) on d1, d15 and d30. TME
was performed 5 weeks later. Acute toxicities were recorded separately for
each modality according to NCI-CTC-AE criteria.
Result: 60 (Arm A) and 62 (Arm B) patients with LARC (< 12 cm from anal
verge), stages II-IV in 8.3%, 88.4% and 3.3% (A) and 1.6%, 90.3% and 8.1%
(B), resp., were included. 54 (A) and 58 (B) patients underwent TME surgery.
In both cohorts, postsurgical AEs (grades ≥ 2) within 30 days aer TME
occurred in 50%, mainly as bladder voiding disorders (BVD) in 13.0% vs
32.7%, wound healing disorders (WHD) in 20.5% vs 18.9% and anastomotic
leaks (AL) in 13.0% vs 29.3%. Grade ≥ 3 complications occurred in 20.4%
vs 31.0%, mainly as WHD in 11.2% vs 6.9% and AL in 9.3% vs 10.3%. More
detailed results will be presented at DKK 2024.
Discussion: e avoidance as well as management of postsurgical compli-
cations in LARC patients is important, but the TNT sequence oers both,
a higher adherence to systemic treatment (CTx) and adequate time for
reconstitution of postsurgical AEs.
Conclusion: TNT seemed to be associated with a higher rate of postsur-
gical AEs (all grades), but the management of AEs (grade ≥ 3) did not
disturb any further adjuvant CTx (like FOLFOX).
Disclosure Statement: e authors declare no conict of interest.
909
Barriers and facilitators to colorectal cancer screening among
migrants – a scoping review
Diana Wahidie; Alena Allak; Yüce Yılmaz-Aslan; Patrick Brzoska
Witten/Herdecke University, Faculty of Health, School of Medicine, Health
Services Research, Witten, Deutschland
Background: Studies from various European countries show that
migrants participate less frequently in colorectal cancer screening than
the majority population. e aim of the present study was to determine
the barriers that migrants face in seeking colorectal cancer screening and
to identify the factors that facilitate informed decision making regarding
the use of this type of cancer screening.
Methods: A scoping review was performed that comprised all German-
and English-language publications, including “gray” literature, since 2002.
A search strategy was used to search the PubMed, CINAHL, and PsycInfo
databases, as well as Google Search and Google Scholar. Hits were
screened for inclusion or exclusion based on titles, abstracts, and full texts.
Result: 58 publications were included in the analysis of this study. Based
on the results of these publications, 15 categories of barriers and facilita-
tors were identied: access, religion, culture and fatalism, shame, discom-
fort and fear, knowledge and awareness, language and literacy skills, trust
in the health care system, risk perception, education about colorectal can-
cer and screening, cultural sensitivity of the care system, use of multipli-
ers and patient navigators, promotion of self-ecacy, empowerment and
participation, social support, trusting doctor-patient relationship, family
history, legal regulations to improve care structures.
Discussion: e results indicate dierent barriers aecting access to col-
orectal cancer screening for migrants. As a limitation, it should be noted
that a large proportion of the identied articles describe studies con-
ducted in the US and therefore the generalizability of the results to other
countries such as Germany is limited due to the dierent structures in the
health care systems.
Conclusion: Measures addressing access barriers to colorectal cancer
screening for migrants should take into account, in particular, the role of
religious and cultural factors as well as dierent perceptions of disease and
be tailored to migrants’ language skills and limited health literacy.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 63
954
Inuence of diabetes mellitus on the early postoperative
andlong-term oncologic outcome in surgical therapy of
coloncancer
Juliane Kuehnel1; Romy Kreyer1; Ronny Otto2; Ingo Gastinger2;
Roland Croner1; Frank Meyer1
1Dept. of General, Abdominal, Vascular and Transplant Surgery; University
Hospital, Magdeburg, Deutschland
2Institute of Quality Assurance in Operative Medicine, Otto-von-Guericke
University, Magdeburg, Deutschland
Background: Less is known about the impact of diabetes mellitus (DM)
on the postop. outcome in surgical therapy of colon cancer (Ca).
Methods: Prospective multicenter observational study (62 items) over 3
years (2009-2011)
Result: In total, 9,167 patients (pats) were enrolled in the study who were
subclassied into 20.5% diabetic pats (37.8% of them insulin-dependent)
& 79.5% non-diabetic pats (median age of DM/non-DM pats, 73.7 vs. 70.6
[range, 34-97/18-98] yr. – p<0.001; sex ratio [male/female]: 52.9/47.1 vs.
56.2/43.8% - p<0.001). At the time of Ca diagnosis-nding, diabetic pats
already had a sign. higher level of tumor inltration & therefore a higher
UICC level. In addition, DM pats had a signicant higher ASA scoring than
non-DM pats (p<0.001). In particular, insulin-dependent pats showed higher
ASA scorings, such as III-IV. In an overall morbidity of 35.8%, sign. more
general complications were documented in DM pats (p<0.001). Specic
complications were also higher in DM pats but only by trend. Considering
the total hospital lethality of 4.2%, DM pats had a sign. higher rate. In detail,
insulin-dependent pats (5.8%) were found with a sign. higher hospital lethal-
ity compared with non-insulin-dependent pats (5.0%, p<0.001). In compar-
ison to non-diabetic pats, diabetic pats had a signicantly lower 5-yr-overall
survival (OAS) (59.7% vs. 49.8%, p<0.001). Especially, insulin-dependent
DM pats showed a sign. lower 5-yr-OAS of 44.9% compared to 52.7% (w/
no need for insulin; p<0.001). In summary, multivariable analysis identied
DM, in particular, insulin-dependent DM, as an independent risk factor of a
worse 5-y-OAS (HR=1.24 [95-CI: 1.10-1.38]; p<0.001) and 5-yr-disease-free
survival (DFS) (HR=1.23 [95-CI: 1.07-1.41]; p=0.004).
Conclusion: A higher postop. complication rate as well as a lower
5-yr-OAS and 5-yr-DFS were found in diabetic pats. Insulin-dependent
diabetics & the higher risk potential of DM pats may have the potential for
a disfavorable long-term outcome.
Disclosure Statement: e authors declare no conict of interest.
962
Upfront surgery in upper rectal cancer (UICC-II/III) followed
byFOLFOX – adverse events and survival
Philine-Sophie Hoyer; Charlotte de Boer; Johannes Martens;
Laura Regina Werle; Luca-Patrice Borgwardt; Johanna Kreutzer;
Julie Schanz; Timotheus Ritter; Andreas Leha; Torsten Liersch
Universitätsmedizin Göttingen, Göttingen, Deutschland
Background: In this single site analyses, we evaluate safety, feasibil-
ity, and ecacy of FOLFOX in patients of the GAST-05 phase-IIb trial
(ISRCTN35198481) with upper rectal cancer (stages II/III, ≥12 cm above
anal verge) following peri-/postoperatively quality controlled total vs par-
tial mesorectal excision (TME vs PME).
Methods: 98 patients (median age: 69 years, range: 38 – 87 years) under-
went upfront surgery followed by 4 cycles FOLFOX (FA: 0.4 g/m², 5-FU:
2.4 g/m², OX: 0.1 g/m²) aer conrmation of UICC stages II/III. e
occurrence of acute/late adverse events (NCI-CTC-AE grades 1 to 4, vs 3.0)
was recorded. Survival was calculated using the logrank test, Kaplan-Meier
estimator, and multivariable Cox proportional hazard regression models.
Results: 79.5% patients (stages II/III in 30 and 32 pats) started adCTx
which was applied in 96.6%. In total, 772 AEs (all grades) occurred,
mainly due to hematologic (26.6%), gastrointestinal (GI) (28.6%),
and neurologic (19.6%) AEs. During follow-up (in median >5 years),
chronic neurotoxicity was present in 24.4% and diarrhea in 34.7%. A low
anterior resection syndrome (LARS, all grades) was diagnosed in 44.1%
and most frequent aer TME (p=0.007). e presence of LARS did not
depend on the application of CTx (p=0.209). Stage III patients showed
5-year DFS of 65.6% (vs. 40.0% without adCTx; p=0.058); 5-year OS
was 78.1% (vs. 40.0% without adCTx, p=0.003) and 8-months land-
mark analyses conrmed a benet in OS aer adCTx (p = 0.0043).
However, further analyses of LARS and its impact (esp. on QoL) will be
presented at DKK 2024 in detail.
Discussion: Although patients showed improved survival rates aer
upfront surgery and FOLFOX, the dominating gastrointestinal AEs
should not be overlooked. With LARS occurring in 44.1%, we suggest
screening patients at staging, during MTT and at follow-up visits.
Conclusion: Aer upfront surgery in upper rectal cancer (stage III)
FOLFOX oers improved OS and is associated with a tolerable safety pro-
le and high adherence.
Disclosure Statement: e authors declare no conict of interest.
Gastrointestinal Cancer: other than colorectal
66
Characterization of long-term survivors in the TOPAZ-1 study
of durvalumab or placebo plus gemcitabine and cisplatin
inadvanced biliary tract cancer
Fabian Finkelmeier1; Mohamed Bouattour2; Juan Valle3; Arndt Vogel4;
Jin Won Kim5; Masayuki Kitano6; Jen-Shi Chen7,8; Howard Burris9;
Renata Zaucha10; Shukui Qin11; Ludovic Evesque12; David B. Zhen13;
Vineet Govinda Gupta14; Joon Oh Park15; Magdalena Żotkiewicz16;
Nana Rokutanda17; Gordon Cohen17; Do-Youn Oh18
1Department of Gastroenterology, Hepatology and Endocrinology, University
Hospital Frankfurt, Frankfurt, Deutschland
2Department of Liver Cancer Unit, Assistance Publique–Hôpitaux de Paris
Hôpital Beaujon, Paris, Frankreich
3Division of Cancer Sciences, The University of Manchester/The Christie NHS
Foundation Trust, Manchester, United Kingdom
4Gastroenterology, Hepatology and Endocrinology, Hanover Medical School,
Hanover, Deutschland
5Division of Medical Oncology, Department of Internal Medicine, Seoul National
University Bundang Hospital, Seoul National University College of Medicine,
Seongnam, Republik Korea
6Second Department of Internal Medicine, Wakayama Medical University,
Wakayama, Japan
7Department of Hematology-Oncology, Linkou Chang-Gung Memorial Hospital,
Tao-yuan City, Taiwan
8Chang-Gung University, Tao-yuan City, Taiwan
9Sarah Cannon Research Institute, Tennessee Oncology, Nashville, USA
10Department of Oncology and Radiotherapy, Medical University of Gdańsk,
Gdańsk, Polen
11Cancer Center of Nanjing, Jinling Hospital, Nanjing, China, VR
12Le Centre Antoine Lacassagne, Département d’Oncologie Médicale, Nice,
Frankreich
13Division of Medical Oncology, Department of Medicine, University of
Washington, Fred Hutchinson Cancer Center, Seattle, USA
14Artemis Hospitals, Gurugram, Indien
15Division of Hematology-Oncology, Department of Medicine, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, Republik Korea
16AstraZeneca, Warsaw, Polen
17AstraZeneca, Gaithersburg, USA
18Division of Medical Oncology, Department of Internal Medicine, Seoul
National University Hospital, Cancer Research Institute, Seoul National
University College of Medicine, Seoul, Republik Korea
Background: TOPAZ-1 (NCT03875235; data cut-o [DCO] Aug 11,
2021), durvalumab (D) + gemcitabine & cisplatin (GC) signicantly
improved overall survival (OS) vs placebo (P) + GC in patients (pts) with
advanced biliary tract cancer (BTC), with OS curves that separated over
time (Oh et al. NEJM Evid 2022), and persisted with further follow-up
(DCO Feb 25, 2022; HR=0.76 [95% CI, 0.64–0.91]; 18-month OS, 34.8%
[D + GC] vs 24.1% [P + GC]; Oh et al. Ann Oncol 2022 Abs 56P). We
characterized long-term survivors (LTS).
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts64
Methods: Pts untreated for unresectable locally advanced, recurrent or
metastatic BTC received D (1500 mg every 3 weeks [Q3W]) or P, + G
(1000 mg/m2) and C (25 mg/m2) on days 1 and 8 Q3W for ≤8 cycles,
followed by D (1500mg Q4W) or P. Characteristics and outcomes of LTS
(alive ≥18 months aer randomization; DCO Feb 25, 2022) were assessed.
Result: ere were more LTS with D + GC vs P + GC. Characteristics of LTS
were consistent with the full analysis set (FAS, all randomized pts) includ-
ing age, sex, region, primary tumor location, metastatic vs locally advanced
BTC and PD-L1 status. Recurrent BTC was more oen than initially unre-
sectable BTC in LTS vs FAS. Median exposure to study therapy in months
was 11.3 (D), 9.7 (P) and 5.5 (GC, both arms) in LTS vs 7.3 (D), 5.8 (P) and
5.1 (GC, both arms) in FAS. e objective response rate in LTS was 44.3%
for D + GC vs 33.8% for P + GC, and greater for both groups vs FAS (26.7%,
D + GC; 18.7%, P + GC). A higher proportion of LTS in the P + GC group
received subsequent anticancer therapy, including immunotherapy, than
LTS in the D + GC group. Frequency of treatment-related adverse events
leading to discontinuation in LTS was consistent with FAS.
Discussion: -
Conclusion: In TOPAZ-1, characteristics of LTS were generally consistent
with the FAS. Overall, LTS were more common with D + GC; LTS in the
P+ GC group appear to be associated with higher frequency of subse-
quent treatments, including immunotherapy.
Indication of source: ©2023 American Society of Clinical Oncology. Reused
with permission. is abstract was previously presented at the 2023 ASCO-GI
Symposium. All rights reserved.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
70
Nivolumab (NIVO) plus chemotherapy (chemo) vs
chemo as rst-line (1L) treatment for advanced gastric
cancer/gastroesophageal junction cancer/esophageal
adenocarcinoma (GC/GEJC/EAC): 3-year follow-up from
CheckMate 649
Markus Möhler1; Yelena Y. Janjigian2; Kohei Shitara3; Marcelo Garrido4;
Carlos Gallardo5; Lin Shen6; Kensei Yamaguchi7; Lucjan Wyrwicz8;
Tomasz Skoczylas9; Arinilda Bragagnoli10; Tianshu Liu11;
Mustapha Tehfe12; Elena Elimova13; Ricardo Bruges14; James M. Cleary15;
Michalis Karamouzis16; Samira Soleymani17; Ming Lei17;
Carlos Amaya Chanaga17; Jaer A. Ajani18
1Johannes-Gutenberg University Clinic, Maniz, Deutschland
2Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College,
New York, NY, USA
3National Cancer Center Hospital East, Kashiwa, Japan
4Clinica San Carlos de Apoquindo, Ponticia Universidad Católica, Santiago,
Chile
5Fundación Arturo López Pérez, Providencia, Chile
6Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis
and Translational Research (Ministry of Education/Beijing), Peking University
Cancer Hospital & Institute, Beijing, China, VR
7The Cancer Institute Hospital of JFCR, Tokyo, Japan
8Klinika Onkologii i Radioterapii, Narodowy Instytut Onkologii, Warszawa, Polen
9II Klinika Chirurgii Ogólnej, Gastroenterologicznej i Nowotworów Układu
Pokarmowego, Medical University of Lublin, Lublin, Polen
10Fundacao Pio Xii Hosp Cancer De Barretos, Barretos, Brasilien
11Zhongshan Hospital Fudan University, Shanghai, China, VR
12Oncology Center–Centre Hospitalier de l’Universite de Montreal, Montreal,
Canada
13Princess Margaret Cancer Centre, Toronto, Kanada
14Instituto Nacional de Cancerologia E.S.E., Bogotá, Kolumbien
15Dana Farber Cancer Institute, Boston, MA, USA
16Laiko General Hospital of Athens, Athens, Griechenland
17Bristol Myers Squibb, Princeton, NJ, USA
18The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Background: NIVO + chemo demonstrated superior overall survival
(OS) and clinically meaningful progression-free survival (PFS) benet vs
chemo and acceptable safety in previously untreated patients (pts) with
advanced GC/GEJC/EAC, leading to approvals in multiple countries.
We present ecacy and safety analyses from the 3-year follow-up of
CheckMate 649.
Methods: Adults with previously untreated, unresectable advanced, or
metastatic GC/GEJC/EAC were enrolled, regardless of programmed
death ligand 1 (PD-L1) expression, excluding pts with known HER2-
positive status. Pts were randomized to NIVO (360 mg Q3W or 240 mg
Q2W) + chemo (XELOX Q3W or FOLFOX Q2W), NIVO + ipilimumab,
or chemo. Primary endpoints for NIVO + chemo vs chemo were OS and
PFS by blinded independent central review in pts with PD-L1 combined
positive score (CPS) ≥ 5.
Results: 1581 pts were concurrently randomized to NIVO + chemo or
chemo. Aer 36-month (mo) minimum follow-up, median OS with
NIVO + chemo vs chemo for PD-L1 CPS ≥ 5 was 14.4 mo (95% CI 13.1–
16.2) vs 11.1 mo (95% CI 10.0–12.1; HR 0.70 [95% CI 0.61–0.81]) and for
all randomized was 13.7 mo (95% CI 12.4–14.5) vs 11.6 mo (95% CI 10.9–
12.5; HR 0.79 [95% CI 0.71–0.88]), respectively. Median PFS with NIVO
+ chemo vs chemo for PD-L1 CPS ≥ 5 was 8.3 mo (95% CI 7.0–9.3) vs 6.1
mo (95% CI 5.6–6.9; HR 0.70 [95% CI 0.60–0.81]) and for all randomized
was 7.7 mos (95% CI 7.1–8.6) vs 6.9 mo (95% CI 6.7–7.2; HR 0.79 [95% CI
0.71–0.89]), respectively. Objective response rate (ORR) was higher and
responses were more durable with NIVO + chemo vs chemo (PD-L1 CPS
≥ 5: ORR, 60% vs 45%; median duration of response [mDOR], 9.6 mo
vs 7.0 mo; all randomized: ORR, 58% vs 46%, mDOR, 8.5 mo vs 6.9 mo,
respectively). OS benet with NIVO + chemo was observed across most
prespecied subgroups. No new safety signals were identied.
Discussion: Aer 3 years of follow-up, NIVO + chemo continued to
demonstrate clinically meaningful long-term survival benet with accept-
able safety.
Conclusions: ese results further support using NIVO + chemo as stan-
dard 1L treatment in previously untreated advanced GC/GEJC/EAC.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
88
Organization, function and gene expression of tertiary
lymphoid structures in pancreatic cancer resembles lymphoid
follicles in secondary lymphoid organs and their abundance is
related to superior survival
Jonas Lehmann1; Martin Thelen1; Simon Schran1; Ella Preugszat1; Maria A.
Garcia-Marquez1; Philipp Lohneis2,3; Heike Löser3,4; Felix Popp5; Stephan
Kruger6; Stefan Böck6; Steen Ormanns6; Christiane J. Bruns5; Alexander
Quaas3; Michael von Bergwelt-Baildon1,6,7; Kerstin Wennhold1;
Hans A. Schlößer1,5
1Center for molecular medicine cologne (CMMC), Köln, Deutschland
2Hämatopathologie Lübeck, Lübeck, Deutschland
3Institute of Pathology, University of Cologne, Faculty of Medicine and
University Hospital Cologne, Köln, Deutschland
4Pathologie Köln-Deutz, Köln, Deutschland
5Department of General, Visceral, Cancer and Transplantation Surgery,
University of Cologne, Faculty of Medicine and University Hospital Cologne,
Köln, Deutschland
6Department of Internal Medicine III, University Hospital, Ludwig Maximilians
University, München, Deutschland
7German Cancer Consortium (DKTK), Heidelberg, Deutschland
Background: Tertiary lymphoid structures (TLS) have been described in
close proximity to tumor areas in a variety of cancer types, where they
are assumed to represent hotspots for T cell and B-cell activation leading
to tumor-specic immune responses. us, abundance of TLS is related
to cancer-specic survival and susceptibility to immune checkpoint
inhibition.
Methods: To identify shared and TLS/secondary lymphoid organ (SLO)-
specic features we performed immunohistochemistry staining and
5-color immunouorescence (IF) of previously untreated pancreatic duc-
tal adenocarcinoma (PDAC) samples. NanoString-based RNA expression
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 65
analysis of laser microdissected tissue was conducted for 12 patients to
compare gene expression in TLS, PDAC, SLOs and normal pancreatic
tissue. B-cell receptor sequencing was performed to determine clonal
expansion.
Result: PDAC patients with a high abundance of TLS inside and sur-
rounding the tumor showed a higher overall survival and TLS abundance
correlated with inltration of T cells in the tumor microenvironment. IF
revealed structural homologies between TLS and SLO with a similar dis-
tribution of B cells, T cells, follicular dendritic cells and lymphatic ves-
sels. In addition, we found largely overlapping expression patterns of a
variety of immune related gene clusters. However, especially expression
levels of T-cell and complement-associated genes were distinct. Most TLS
expressed Ki-67, Pax5, AID and IgG, proving proliferation, class switching
and anity maturation of B cells in close proximity to the tumor. B-cell
receptor sequencing of microdissected TLS and SLO, identied an overlap
of expanded sequences.
Discussion: Our analyses of organization, function and gene expression
patterns revealed a high overlap between SLOs and TLS in PDAC.
Conclusion: ese results indicate a role of TLS in cancer immunosur-
veillance of PDAC, which may be susceptible to therapeutic targeting in
this highly aggressive and immunotherapy-resistant disease.
Disclosure Statement: e authors declare no conict of interest.
140
Health-related quality of life (HRQOL) in patients with
advanced gastric, gastroesophageal junction, or esophageal
adenocarcinoma cancer (GC/GEJC/EAC): 36-month results of
CheckMate 649 nivolumab plus chemotherapy (N+C) vs (C)
Markus Möhler1; Lucjan Wyrwicz2; Clara Chen3; Eric Davenport4;
Jinyi Wang4; Raheel Nathani3; Kaoru Kondo3; Elena Elimova5
1Johannes-Gutenberg University, Mainz, Deutschland
2Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw,
Polen
3Bristol Myers Squibb, Princeton, NJ, USA
4RTI International, Research Triangle Park, NC, USA
5Princess Margaret Cancer Centre, Toronto, Kanada
Background: Primary results of CheckMate 649 showed significant
improvement in overall survival (OS) and progression-free survival (PFS)
with rst-line (1L) N+C vs C in patients (pts) with GC/GEJC/EAC and
programmed death ligand 1 (PD-L1) combined positive score (CPS) ≥ 5.
HRQOL was maintained at 24-month (mo) follow-up (FU) and risk of
deterioration was lower with N+C vs C. We report exploratory analyses at
36-mo FU in pts with PD-L1 CPS ≥ 5.
Methods: Functional Assessment of Cancer erapy-Gastric Cancer
(FACT-Ga) and EQ-5D-3L (EQ-5D) were performed at baseline (BL) and
every 6 weeks during treatment. Longitudinal change from BL in EQ-5D
Visual Analog Scale, Utility Index (UI), FACT-Ga total score, and subscales
were analyzed using a mixed model for repeated measures. FACT-Ga GP5
(“I am bothered by side eects of treatment”) item responses were ana-
lyzed descriptively. Time to first symptom deterioration (TTSD) and time
until definitive deterioration (TuDD) were estimated using Kaplan-Meier
estimators and stratified Cox models; deterioration/improvement was
based on prespecified thresholds.
Results: 1581 pts were randomized; 955 had PD-L1 CPS ≥ 5, and 822 pts
with both BL and post-BL patient-reported outcomes (N+C, n = 422; C,
n = 400). N+C was favored at most time points for EQ-5D, FACT-Ga total,
Gastric Cancer Subscale (GaCS), and Physical Well-Being scores and were
comparable for other FACT subscale scores. Pts treated with N+C were no
more bothered by side eects than pts treated with C alone. TTSD favored
N+C vs C (HR < 1) and significant decreased risk of deterioration, with
HR and 95% CI < 1, was seen in EQ-5D UI, FACT-Ga total score, and
GaCS subscale. TuDD showed significant delays in deterioration for all
scale scores (HR and 95% CI < 1).
Discussion: HRQOL scores across measures favored N+C vs C at most
time points. N+C decreased deterioration risk vs C.
Conclusions: e 36-mo FU results confirm the 24-mo FU findings
that pts generally maintained HRQOL with N+C vs C. Along with the
improvement of OS and PFS, these results suggest favorable benefits for
1L N+C in pts with PD-L1 CPS ≥ 5.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
149
Trastuzumab from ToGA to real world routine practice, report
from North West Cancer Centre Northern Ireland
Hossam Abdulkhalek1; Fatema Mohammad2; Lorna Cairns1; Conor Oneill1
1North West Cancer Centre, Western Health & Social Care Trust, Londonderry,
Northern Ireland
2Ulster University, Coleraine, United Kingdom
Introduction: Oesophageal and gastric cancers are among common can-
cer sites across the world and one year survival rates for oesophageal and
gastric cancer are 23% and 21% respectively. In the pivotal Trastuzumab
for Gastric Cancer (ToGA) trial, Trastuzumab improved median survival
in patients with advanced HER2 positive gastroesophageal cancer from
11.1 to 13.8 months.
Method: Data items for collection were identied through the NICE
guidelines. Datasets from Electronic Case Record were extracted with an
incident date of diagnosis between 01/01/2018 to 31/12/2021. Data ret-
rospectively reviewed and assessed for the Trastuzumab treated group in
comparison to previously published data.
Results: Total of 14 patients with oesophageal, gastroesophageal and
gastric cancer received Trastuzumab. All patients (14/14) had conrmed
HER2 positive stage IV adenocarcinoma (IHC+3). e mean age was 66
years, 71% (10/14) were male, 79% (11/14) had junctional adenocarci-
noma while 21% had gastric adenocarcinoma. Baseline cardiac functions
assessed by obtaining 2D echocardiography in 100% (14/14) patients and
follow up echocardiography obtained in accordance to NICE guidance,
cardiac side eects are recognized in 0% (0/14) patients. Trastuzumab was
discontinued in 57% (8/14) and in 7% (1/14) due to disease progression
or intolerance respectively. 3 patients (21%) are still alive at the time of
the report. Median number of cycles of Trastuzumab was 12 (range 1- 34)
and 57% (8/14) were able to complete 6 cycles of Trastuzumab and che-
motherapy. Median overall survival was 10 months and cumulative 1 year
survival rate was 22%.
Conclusion: e outcome for our patients is comparable to the published
regional and national data. e median survival of our patients treated
with Trastuzumab is less than what was reported in the ToGA trial, how-
ever the number of patients is too small to conclude that. More real-world
studies will oer more insight into our patients’ outcomes.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts66
188
Nal-IRI with 5-uorouracil and leucovorin or gemcitabine plus
cisplatin in advanced biliary tract cancer, a phase 2 study of
the AIO hepatobiliary and YMO cancer groups (NIFE-AIO-YMO
HEP-0315) - updated survival and QoL results
Lukas Perkhofer1; Dominik Paul Modest2; Marianne Sinn3; Jana Käthe
Strieer3; Bernhard Opitz4; Thorsten O. Goetze5; Eike Gallmeier6;
Stefan Angermeier7; Ludwig Fischer von Weikersthal8; Lutz Jacobasch9;
Dirk Waldschmidt10; Michael Niedermeier11; Michael Sohm12;
Disorn Sookthai13; Marina Schaaf13; Axel Hinke14; Thomas Seuerlein1;
Thomas J. Ettrich1
1Universitätsklinikum Ulm, Ulm, Deutschland
2Charité - Universitätsmedizin Berlin, Berlin, Deutschland
3Universitätsklinikum Hamburg Eppendorf, Hamburg, Deutschland
4Krankenhaus St. Elisabeth and St. Barbara Halle, Halle, Deutschland
5Krankenhaus Nordwest, Frankfurt am Main, Deutschland
6Klinikum Memmingen, Memmingen, Deutschland
7Klinikum Ludwigsburg, Ludwigsburg, Deutschland
8Klinikum St. Marien Amberg, Amberg, Deutschland
9Hämatologie/Onkologie Dresden, Dresden, Deutschland
10Uniklinik Köln, Köln, Deutschland
11Hämatologie/Onkologie Memmingen, Memmingen, Deutschland
12Hämatologie/Onkologie Landshut, Landshut, Deutschland
13IKF, Frankfurt am Main, Deutschland
14CCRC Cancer Clinical Research Consulting, Düsseldorf, Deutschland
Background: In the NIFE study the combination of nanoliposomal-irino-
tecan (nal-IRI) plus 5-FU/leucovorin (5-FU/LV) was evaluated as a
1st-line therapy option in advanced biliary tract cancer (BTC), compared
to the standard of care gemcitabine/cisplatin (G/C). Here we present the
updated overall survival data and quality of life evaluation.
Methods: NIFE is a prospective, open label, randomized, multicenter
phase 2 study. Advanced BTC patients were randomized (1:1) to receive
nal-IRI/5-FU/LV (arm A) or G/C (arm B). Stratication parameters were
intrahepatic vs. extrahepatic BTC, sex and ECOG (0/1). e primary
endpoint was progression free survival (PFS) at 4 months in the ITT
and required at ≥50% of subjects being progression free to reject the null
hypothesis in arm A (90% power, type I error 0.05). Quality of life ques-
tionnaires were repetitively recorded throughout the therapy (EORTC
QLQ-BIL21, QLQ-C30).
Result: Between 2018 and 2020 91 patients were randomly assigned to
receive either nal-IRI/5-FU/LV (n=49) or gemcitabine/cisplatin (n=42).
e NIFE trial met its primary endpoint with a 4 months PFS-rate of
51% in patients receiving nal-IRI/5-FU/LV. e exploratory comparison
of the study arms consistently suggested a numerical but statistically not
signicant survival benet for patients receiving nal-IRI/5-FU/LV over
time. Within the study no unexpected toxicities occurred. Change from
baseline was noted in the EORTC QLQ-C30 global health-related quali-
ty-of-life score and showed no clinically meaningful dierences between
both treatment arms. Further detailed QoL analysis is pending.
Discussion: Nal-IRI/5-FU/LV showed ecacy in 1st line therapy of
advanced BTC, however interpretation has to be taken with caution due to
relatively small patient number. erefore, this regimen needs validation
in a larger phase 3 trial.
Conclusion: Treatment with nal-IRI/5-FU/LV consistently demonstrated
ecacy in the 1st-line therapy of advanced BTC with maintained quality
of life.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
304
Perioperative Therapie mit FLOT4 verlängert signikant das
Überleben bei Patienten mit Magenkarzinom und AEG-Tumor
in einer großen Real-World-Kohorte
Christian Möhring1; Adrianna Mańczak1; Aliki Timotheou1;
Farsaneh Sadeghlar1; Taotao Zhou1; Robert Mahn1;
Malte Benedikt Monin1; Marieta Toma2; Georg Feldmann3; Peter Brossart3;
Muemtaz Koeksal4; Gustavo Sarria4; Nils Sommer5; Philipp Lingohr5;
Azin Jafari5; Jörg Kal5; Christian P Strassburg1;
Maria Angeles Gonzalez-Carmona1
1Medizinische Klinik und Poliklinik I - Universitätsklinikum Bonn, Bonn,
Deutschland
2Institut für Pathologie, Bonn, Deutschland
3Universitätsklinikum Bonn Medizin.Klinik III - Hämatologie und Onkologie,
Bonn, Deutschland
4Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn,
Bonn, Deutschland
5Klinik und Poliklinik für Allgemeine Chirurgie, Viszeral-, Thorax- und
Gefäßchirurgie, Bonn, Deutschland
Background: Seit 2019 ist das FLOT4 Schema der neue perioperative
Chemotherapiestandard für Patienten mit lokal fortgeschrittenem AEG-
Tumor und Magenkarzinom. Ob sich die Daten der FLOT4-Studie auch
in einem unselektierten Patientenkollektiv reproduzieren lassen, ist bisher
nur unzureichend untersucht. In dieser Arbeit haben wir eine große Real-
World-Kohorte von Patienten mit AEG-Tumor und Magenkarzinom
untersucht und die Eektivität und Verträglichkeit von FLOT4 mit der
von 5-FU/Platinderivat basierten Protokollen verglichen.
Methods: In die retrospektive Studie wurden Patienten mit lokal fortges-
chrittenem AEG-Tumor und Magenkarzinom eingeschlossen, die entweder
perioperativ mittels FLOT4-Protokoll oder 5-FU/Platinderivat basier-
tem Protokoll zwischen 2010 und 2022 im Uniklinikum Bonn behandelt
wurden (n=99). Das Gesamtüberleben, das krankheitsfreie Überleben,
erapieansprechen und erapiekomplikationen wurden analysiert.
Result: Mit FLOT4 behandelte Patienten (n=55) hatten ein statistisch
signikant längeres medianes Gesamtüberleben von 57,8 Monaten ver-
glichen mit 28,9 Monaten unter 5-FU/Platinumderivat (n=44) (HR:
0,554, 95% KI: 0,317 – 0,969, p=0,036). Das mediane krankheitsfreie
Überleben war ebenfalls in der FLOT-Gruppe verlängert, jedoch nicht
statistisch signikant (54,2 vs. 18,0 Monate, p=0,179). Die pathologische
Tumorregression nach Becker war signikant besser in der FLOT-Gruppe
(p=0.001). Die Subgruppenanalyse zeigte ein größeren erapievorteil für
Patienten mit AEG-Tumor und Nicht-Siegelringzellkarzinom.
Discussion: FLOT4 war auch in einer nicht selektierten Patientenkohorte
im Hinblick auf Gesamtüberleben und pathologisches Ansprechen eek-
tiver als der ehemalige erapiestandard aus 5-FU und Platinumderivat.
Interessanterweise protierten Patienten mit AEG-Tumoren mehr und
Patienten mit Siegelringzellkarzinom weniger von der erapie mit FLOT4.
Conclusion: Die Ergebnisse der vorliegenden Arbeit bestätigen die Daten
aus den prospektiven Phase II/III Studien.
Disclosure Statement: e authors declare the following: MG has contributed to
advisory boards for Roche, Eisai, BMS, MSD and AZ.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 67
351
Impact of viral aetiology in the Phase 3 HIMALAYA study
of tremelimumab (T) plus durvalumab (D) in unresectable
hepatocellular carcinoma (uHCC)
Stephen L Chan1; Masatoshi Kudo2; Bruno Sangro3; Katie Kelley4;
Junji Furuse5; Joong-Won Park6; Patrapim Sunpaweravong7;
Angelica Fasolo8; Thomas Yau9; Tomokazu Kawaoka10; Ann-LI Cheng11;
Sergio Azevedo12; María Reig13; Eric Assenat14; Mark Yarchoan15;
Aiwu R He16; Mallory Makowsky17; DI Ran17; Alejandra Negro17;
Thomas J. Ettrich18; Ghassan Abou-Alfa19,20,21
1State Key Laboratory of Translational Oncology, Department of Clinical
Oncology, Sir Yue-Kong Pao Center for Cancer, The Chinese University of Hong
Kong, Hong Kong, Hong Kong
2Department of Gastroenterology and Hepatology, Kindai University Faculty of
Medicine, Osaka, Japan
3Liver Unit and HPB Oncology Area, Clínica Universidad de Navarra and
CIBEREHD, Pamplona, Spanien
4Helen Diller Family Comprehensive Cancer Center, University of California, San
Francisco, USA
5Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan
6Department of Gastroenterology and Hepatology, Center for Liver and
Pancreatobiliary Cancer, National Cancer Center, Goyang, Republik Korea
7Department of Medicine, Prince of Songkla University Hospital, Songkhla,
Thailand
8Fondazione Michelangelo, Mailand, Italien
9Queen Mary Hospital, Pok Fu Lam, Hong Kong, Hong Kong
10Department of Gastroenterology and Metabolism, Hiroshima University,
Hiroshima, Japan
11National Taiwan University Cancer Center and National Taiwan University
Hospital, Taipei, Taiwan
12UPCO- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brasilien
13Barcelona Clinic Liver Cancer (BCLC), Liver Unit, Hospital Clinic de Barcelona,
IDIBAPS, CIBEREHD, University of Barcelona, Barcelona, Spanien
14Department of Medical Oncology, Saint Eloi Hospital, Montpellier University,
Montpellier, Frankreich
15Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, USA
16Division of Hematology and Oncology, Lombardi Comprehensive Cancer
Center, Georgetown University, Washington, USA
17AstraZeneca, Gaithersburg, USA
18University Hospital Ulm, Comprehensive Cancer Center Ulm, Ulm,
Deutschland
19Department of Medicine, Memorial Sloan Kettering Cancer Center, New York,
USA
20Weill Medical College, Cornell University, New York, USA
21Trinity College Dublin, Dublin, Irland
Background: In HIMALAYA (NCT03298451), a single high priming
dose of T plus D (STRIDE) signicantly improved OS vs sorafenib (S),
and D was noninferior to S in uHCC (Abou-Alfa et al. NEJM Evid 2022).
Viral aetiology is associated with hepatic impairment in HCC develop-
ment and may inuence immunotherapy activity. We analysed the impact
of viral aetiology on clinical outcomes.
Methods: is exploratory analysis assessed STRIDE, D and S in pts
with HBV (presence of HBsAg and/or anti-HBcAb with detectable HBV
DNA), HCV or nonviral/other (NV) aetiology. OS HR were calculated
using a Cox proportional hazards model. As subsets were not sized for
formal comparisons, no multiplicity adjustments were made. A post hoc
multivariate analysis was used to identify chance imbalances in key prog-
nostic factors that may bias estimated treatment eects.
Result: Baseline demographic and disease characteristics were similar
across treatment arms in the HBV and NV subsets. In the HCV group,
multivariate analysis identied imbalances in two prognostic variables:
extrahepatic spread (EHS; more frequent for STRIDE than S) and ALBI
(score ≥2 more frequent for STRIDE and D than S). OS and PFS were
improved with STRIDE vs S in the HBV and NV groups, but not in the
HCV group. Using a stratied Cox proportional hazards model to account
for imbalances in EHS and ALBI in the HCV subset, OS HRs favoured
STRIDE vs S. OS HRs favoured STRIDE when adjusting for EHS and
ALBI in the other subgroups and in aetiological subgroups. Results for D
vs S showed similar trends.
Conclusion: In HIMALAYA, OS favoured STRIDE vs S across aetiolog-
ical subgroups when subsets were adjusted for prognostic factor imbal-
ances in the HCV cohort; similar trends were observed with D vs S across
subsets. ese results conrm the benets of STRIDE and D in pts with
uHCC, irrespective of underlying aetiology.
Funding: AstraZeneca
Previously presented at ESMO 2022, 714P: Impact of viral aetiology in the Phase3
HIMALAYA study of tremelimumab (T) plus durvalumab (D) in unresectable
hepatocellular carcinoma (uHCC), Stephen L Chan et al. - Reused with
permission.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
367
Phase 1b Results of Bemarituzumab
(BEMA)+mFOLFOX6+Nivolumab (NIVO) for Advanced Gastric/
Gastroesophageal Junction Cancer (G/GEJC): FORTITUDE-102
Part 1
Zev Wainberg1; Kensei Yamaguchi2; Jaer A. Ajani3; Jospeh Chao4;
Markus Möhler5; Yoon-Koo Kang6; Eric Van Cutsem7; Priscilla K. Yen8;
DI Zhou9; Telma Murias Dos Santos8; Kohei Shitara10
1University of California at Los Angeles, Department of Medicine, Division
ofHematology and Oncology, Los Angeles, USA
2Cancer Institute Hospital of Japanese Foundation for Cancer Research,
Department of Gastroenterological Chemotherapy, Tokyo, Japan
3The University of Texas MD Anderson Cancer Center, Department of
Gastrointestinal Medical Oncology, Division of Cancer Medicine, Houston, USA
4City of Hope Comprehensive Cancer Center, Duarte, USA
5Johannes-Gutenberg University Clinic, Department of Medicine, Mainz,
Deutschland
6University of Ulsan College of Medicine, Asan Medical Center, Department of
Oncology, Seoul, Republik Korea
7University Hospitals Gasthuisberg Leuven and KU Leuven, Department of
Gastroenterology/Digestive Oncology, Leuven, Belgien
8Amgen Inc, Thousand Oaks, USA
9Amgen Inc, San Francisco, USA
10National Cancer Center Hospital East, Department of Gastroenterology and
Gastrointestinal Oncology, Kashiwa, Japan
Background: In FORTITUDE-102 trial, part 1 (open-label phase [ph] 1b)
evaluated the safety and tolerability of BEMA+mFOLFOX6+NIVO and
part 2 (randomized ph3) the safety and ecacy versus placebo. Here, we
present the results of part 1.
Methods: Up to 20 pts with/without FGFR2b overexpression could be
enrolled. e initial dose of BEMA was 15 mg/kg IV Q2W with one 7.5
mg/kg dose on cycle 1 day 8. e dose-limiting toxicity (DLT) period was
28 days. At least 6 pts were treated at a dose level with less than 33% inci-
dence of DLTs to determine the recommended ph3 dose (RP3D). An ad
hoc review was performed 6 mo aer the DLT period.
Result: Eight enrolled pts (4 Asian and 4 White) were evaluated for DLTs:
age was 50-71 years, 6 pts were men. No DLTs were reported; no new
safety signals were identied. Mean exposures for the rst 3 cycles and
estimated terminal elimination half-life (7-11 days) were consistent with
historical data. No meaningful BEMA exposure changes were observed
with the addition of NIVO, indicating no drug interactions. e RP3D
was 15 mg/kg Q2W with one 7.5 mg/kg dose on cycle 1 day 8. Six mo
post-DLT period, the median treatment duration was 34 weeks (8-40).
Four pts had 6 serious AEs (1 hyponatremia considered BEMA-related);
7 pts had 13 grades ≥3 AEs (4 [neutropenia, mucositis, hyponatremia,
and delirium] in 2 pts considered BEMA-related). Five pts reported 8ocu-
lar AEs of grades ≤2 with a median time to onset of 17 weeks. No AEs
led to BEMA discontinuation. Treatment was interrupted in 4 pts due to
BEMA-related AEs (1 was ocular related). Partial response was seen in 3
pts, stable disease in 4 pts, and progressive disease (PD) in 1 pt. BEMA was
stopped for consent withdrawal in 1 pt and for PD in 2 pts.
Discussion: Updated data will be presented at the congress.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts68
Conclusion: is is the rst time a combination of BEMA, mFOLFOX6,
and NIVO is assessed. In part 1, consistent safety and pharmacokinetic
proles suggest no negative interaction, with no new safety signals aer
6 mo. In part 2, this combination is being studied in G/GEJC pts with
FGFR2b ≥10% tumor cells with moderate to strong membrane staining.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
370
Outcomes by baseline liver function in patients with
unresectable hepatocellular carcinoma treated with
tremelimumab and durvalumab in the Phase 3
HIMALAYA study
Arndt Vogel1,2; Stephen L Chan3; Junji Furuse4; Won Young Tak5;
Gianluca Masi6; Maria Varela7; Jee Hyun Kim8; Suebpong Tanasanvimon9;
María Reig10; Farshid Dayyani11; Mallory Makowsky12;
Michelle Marcovitz12; Alejandra Negro12; Ghassan Abou-Alfa13
1Medizinische Hochschule Hannover, Hannover, Deutschland
2Toronto General Hospital, Toronto, Canada
3Chinesische Universität Hongkong, Hong Kong, China
4Kyorin University School of Medicine, Mitaka, Japan
5Kyungpook National University School of Medicine, Daegu, Republik Korea
6Universität Pisa, Pisa, Italien
7Central University Hospital of Asturias, Oviedo, Spanien
8Seoul National University Bundang Hospital, Seongnam-si, Republik Korea
9Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
10Universitat de Barcelona, Barcelona, Spanien
11University of California, Irvine, USA
12AstraZeneca, Gaithersburg, USA
13Memorial Sloan-Kettering Cancer Center, New York, USA
Background: In HIMALAYA (NCT03298451), a single, high priming
dose of tremelimumab+durvalumab (STRIDE) signicantly improved
overall survival (OS) vs sorafenib and durvalumab was noninferior to
sorafenib (Abou-Alfa et al. 2022) in uHCC. Liver function is frequently
impaired in HCC patients and it is important to evaluate ecacy and
safety of systemic therapies for these patients.
Methods: HIMALAYA included patients with Child-Pugh Score classA.
Baseline liver function was evaluated using albumin-bilirubin (ALBI)
score. Exploratory analyses assessed OS, objective response rate (ORR),
and safety in patients classied into ALBI grade 1 and ALBI grade 2/3
subgroups.
Results: Baseline characteristics in the subgroups were similar across
treatment arms. In ALBI grade 1 patients, mOS (95%CI) was 23.43
months (19.19-28.75) with STRIDE, 21.16 months (17.38-25.86) with
durvalumab, and 19.02 months (15.67-23.16) with sorafenib; 36-month
OS rates were 38.0%, 27.0%, and 27.3%, respectively.
ORRs were 21.7% for STRIDE, 18.7% for durvalumab, and 7.4% for
sorafenib. In ALBI grade 2/3 patients, mOS (95%CI) was 11.30 months
(9.33-14.19) with STRIDE, 12.29 months (9.30-16.03) with durvalumab,
and 9.72 months (7.23-11.76) with sorafenib; 36-month OS rates were
21.8%, 22.5%, and 12.9%, respectively. ORRs were 18.3% for STRIDE,
15.2% for durvalumab, and 2.7% for sorafenib. Safety in the ALBI sub-
groups was generally consistent with the full analysis set.
Discussions: -
Conclusions: STRIDE showed a favorable benet-risk prole compared
with sorafenib across ALBI subgroups. STRIDE and durvalumab may
represent new treatment options in uHCC for patients with less optimal
liver function.
Previously presented at ESMO WCGI 2022, FPN: O-5, Arndt Vogel etal. - Reused
with permission.
Funding: AstraZeneca
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
372
Impact of mutation status on ecacy outcomes in TOPAZ-1:
A Phase 3 study of durvalumab (D) or placebo (PBO) plus
gemcitabine and cisplatin (+GC) in advanced biliary tract
cancer (BTC)
Arndt Vogel1,2; Juan Valle3; Shukui Qin4; Lorenzo Antonuzzo5;
David Tougeron6; Choongkun Lee7; Benjamin Tan8; Masafumi Ikeda9;
Violeta Guthrie10; Patricia Mccoon11; Young Lee10; Nana Rokutanda10;
Magdalena Żotkiewicz12; Gordon Cohen10; Do-Youn Oh7
1Medizinische Hochschule Hannover, Hannover, Deutschland
2Toronto General Hospital, Toronto, Kanada
3Universität Manchester, Manchester, United Kingdom
4Bayi Hospital, Nan Jing Shi, China, VR
5Careggi University Hospital, Firenze, Italien
6Poitiers University Hospital, Poitiers, Frankreich
7Yonsei University College of Medicine, Seoul, Republik Korea
8Washington University School of Medicine, St. Louis, USA
9National Cancer Center Hospital East, Kashiwa, Japan
10AstraZeneca, Gaithersburg, USA
11AstraZeneca, Waltham, USA
12AstraZeneca, Warsaw, Polen
Background: In the double-blind, Phase 3 TOPAZ-1 study
(NCT03875235), overall survival (OS) with D+GC versus PBO+GC
was signicantly improved in patients (pts) with previously untreated
advanced BTC (Oh et al. NEJM Evid 2022; doi:10.1056/EVIDoa2200015).
An exploratory objective of the TOPAZ-1 study was to assess ecacy out-
comes by tumour mutations.
Methods: Eligible pts were randomised 1:1 to receive D+GC or PBO+GC.
Genomic proling of formalin-xed paran-embedded tumour tis-
sues from biomarker-evaluable pts (BEPs) was performed using the
FoundationOne® panel (Foundation Medicine, Cambridge, MA).
Mutation prevalence and outcomes based on the 25 February 2022 data
cut-o were descriptively assessed across subtype and geographical region
subgroups.
Result: BEPs comprised 441/685 pts (64% of full analysis set). TP53,
CDKN2A/CDKN2B/MTAP on chromosome 9p21, KRAS and ARID1A
were the most frequently altered genes. Mutation prevalence varied by
subtype, consistent with previous reports. OS hazard ratios (HR) with
D+GC versus PBO+GC for pts with mutant or wild-type genes that are
clinically actionable with prevalence greater than 3% are shown (IDH1
9%, ERBB2 amplication 8%, BRCA1/BRCA2 4%, BRAF 4%, FGFR2
rearrangement 3%). While prevalence is low for many of the alterations,
HRs<1 are noted for all clinically actionable mutant subtypes except
ERBB2 alterations. However, response rates were nominally higher in the
majority of D+GC vs PBO+GC groups, including ERBB2 alterations, sug-
gesting activity in these subgroups.
Discussion: -
Conclusion: BTC mutation prevalence in TOPAZ-1 by primary tumour
location and geographical region was consistent with other studies.
Although pt numbers were low and the condence intervals were broad,
pts with clinically actionable alterations (IDH1, BRAF and BRCA1/2
mutations and FGFR2 rearrangements) appeared to benet from D+GC.
Previously presented at ESMO Asia Congress, FPN 680, Juan Valle et al., - Reused
with permission.
Funding: AstraZeneca
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 69
375
Immune-mediated adverse event (imAE) incidence, timing
and association with ecacy in the Phase 3 TOPAZ-1 study
of durvalumab (D) or placebo (PBO) plus gemcitabine and
cisplatin (+ GC) in advanced biliary tract cancer (BTC)
Alexander-Otto König1; Lorenzo Antonuzzo2; Hidenori Takahashi3;
Joon Oh Park4; Aumkhae Sookprasert5; Roopinder Gillmore6; Shengshun
Yang7; Juan Cundom8; Mila Petrova9; Gina Vaccaro10; Marielle Holmblad11;
Julia Xiong12; Katrin Heider13; Nana Rokutanda11; Do-Youn Oh14
1Universitätsmedizin Göttingen, Göttingen, Deutschland
2Universität Florenz, Firenze, Italien
3Osaka International Cancer Institute, Osaka, Japan
4Universität Sungkyunkwan, Seoul, Republik Korea
5Khon Kaen University, Khon Kaen, Thailand
6Royal Free Hospital, London, United Kingdom
7Taichung Veterans General Hospital, Taichung, Taiwan
8Instituto de Investigaciones Metabólicas, Buenos Aires, Argentinien
9MHAT Nadezhda, Soa, Bulgarien
10Providence Cancer Institute, Portland, USA
11AstraZeneca, Gaithersburg, USA
12AstraZeneca, Waltham, USA
13AstraZeneca, Cambridge, United Kingdom
14Seoul National University College of Medicine, Seoul, Republik Korea
Background: In TOPAZ-1 (NCT03875235), D + GC signicantly
improved OS vs PBO + GC for patients (pts) with advanced BTC (Oh
D-Y, et al. J Clin Oncol 2022;40(suppl 4). Abs 378). D (immune checkpoint
inhibitor) may cause imAEs; imAEs have been associated with outcome
(Zhou X, et al. BMC Med 2020;18:87).
Methods: Safety was assessed in pts who received ≥1 dose of treatment:
D (1500 mg Q3W) or PBO, + G (1000 mg/m2) and C (25 mg/m2) on
days 1 and 8 Q3W, for up to 8 cycles, followed by D (1500 mg Q4W)
or PBO monotherapy until disease progression or unacceptable toxicity.
imAE (AEs of special/possible interest, linked to drug exposure, likely
immune-mediated mechanism, no clear alternate aetiology) incidences
were calculated by programmatic adjudication.HR and mOS were calcu-
lated using the Kaplan-Meier method. CI for mOS was derived based on
Brookmeyer-Crowley method.
Result: imAEs occurred in more pts in D + GC vs PBO + GC (12.7% vs
4.7%; 1 pt may have >1 imAE). Incidence of Grade 3/4 or serious imAEs
was low; median time to onset (mTTO) varied. e most common imAEs
(>1% of pts in one arm) were hypothyroid events (5.9% vs 1.5%), der-
matitis/rash (3.6% vs 0.3%), hepatic events (1.2% vs 0.6%) and adrenal
insuciency (1.2% vs 0.3%). imAEs in D + GC required concomitant
treatment more frequently than PBO + GC (systemic corticosteroids 8.0%
vs 3.5%, high dose steroids 3.8% vs 2.9%, endocrine therapy 6.5% vs 1.5%,
other immunosuppressant 0.3% vs 0.3%). imAEs were generally manage-
able and consistent with the known safety prole. In D + GC, mOS was
numerically greater in pts with an imAE of any grade (17.3 months; 95%
CI, 12.4–nc]) vs those without (12.6 months; 95% CI, 10.5–13.6; OS HR
0.62; 95% CI, 0.38–0.97).
Dicussion: -
Conclusion: Most imAEs were Grade 1/2 and manageable; imAEs did not
increase discontinuation. imAEs occurred at any time during/aer treat-
ment; mTTO varied depending on type. Although pt numbers are low,
imAEs may be associated with greater OS benet; further investigation
is warranted.
Previously presented at ESMO Congress, FPN 57P, Lorenzo Antonuzzo etal.,
reused with permission.
Funding: AstraZeneca
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
377
Four-year overall survival update from the phase 3
HIMALAYA study of tremelimumab (T) plus durvalumab (D) in
unresectable hepatocellular carcinoma (uHCC)
Bruno Sangro1; Stephen L Chan2; Katie Kelley3; George Lau4; Masatoshi
Kudo5; Wattana Sukeepaisarnjaroen6; Enrico De Toni7; Junji Furuse8;
Yoon-Koo Kang9; Peter R. Galle10; Lorenza Rimassa11,12; Alexandra
Heurgué13; Vincent C. Tam14; Tu Van Dao15; Satheesh Chiradoni
Thungappa16; Valeriy Breder17; Yuriy Ostapenko18; María Reig19; Mallory
Makowsky20; Charu Gupta21; Alejandra Negro20; Ghassan Abou-Alfa22,23,24
1Liver Unit and HPB Oncology Area, Clínica Universidad de Navarra and
CIBEREHD, Pamplona, Spanien
2State Key Laboratory of Translational Oncology, Department of Clinical
Oncology, Sir Yue-Kong Pao Center for Cancer, The Chinese University of Hong
Kong, Hong Kong, Hong Kong
3Helen Diller Family Comprehensive Cancer Center, University of California, San
Francisco, USA
4Humanity and Health Clinical Trial Center, Humanity and Health Medical Group,
Hong Kong, Hong Kong
5Department of Gastroenterology and Hepatology, Kindai University Faculty of
Medicine, Osaka, Japan
6Department of Medicine, Songklanagarind Hospital, Khon Kaen University,
Khon Kaen, Thailand
7Department of Medicine II, University Hospital, LMU Munich, München,
Deutschland
8Kanagawa Cancer Center, Yokohama, Japan
9Department of Oncology, University of Ulsan College of Medicine, Asan
Medical Center, Seoul, Republik Korea
10Department of Internal Medicine I, University Medical Center, Mainz,
Deutschland
11Department of Biomedical Sciences, Humanitas University, Mailand, Italien
12Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Mailand, Italien
13Department of Hepato-Gastroenterology, Robert-Debré Hospital, Reims,
Frankreich
14Tom Baker Cancer Centre, Department of Oncology, University of Calgary,
Calgary, Kanada
15Cancer Research and Clinical Trials Center, Department of Optimal Therapy,
National Cancer Hospital, Hanoi, Vietnam
16Health Care Global Enterprises Ltd, Bangalore, Indien
17N. N. Blokhin Russian Cancer Research Center, Chemotherapy Unit, Moskau,
Russische Föderation
18Department of Minimally Invasive and Endoscopic Surgery, Interventional
Radiology, National Cancer Institute, Kiev, Ukraine
19Barcelona Clinic Liver Cancer (BCLC), Liver Unit, Hospital Clinic de Barcelona,
IDIBAPS, CIBEREHD, University of Barcelona, Barcelona, Spanien
20AstraZeneca, Gaithersburg, USA
21Oncology Biometrics, Late Oncology Statistics, AstraZeneca, Wilmington, USA
22Memorial Sloan Kettering Cancer Center, Cornell University, New York, USA
23Weill Medical College, Cornell University, New York, USA
24Trinity College Dublin, Dublin, Irland
Purpose: In the primary analysis (DCO: 27-Aug 2021) of the HIMALAYA
study (NCT03298451) in uHCC, a single high priming dose of T plus D
(STRIDE) was superior to sorafenib (S), and D mono was noninferior to
S, for OS (Abou-Alfa et al. NEJM Evid 2022). Here, we report the 4-year
OS update.
Method: Pts with uHCC and no previous systemic treatment were ran-
domised to STRIDE (T 300 mg single dose, D 1500 mg Q4W), D mono
(1500 mg Q4W) or S (400 mg bid). Primary EP was OS for STRIDE vs S
(DCO for this analysis: 23-Jan 2023, 78% OS data maturity for STRIDE).
OS and sTRAEs were assessed. Baseline demographics and disease char-
acteristics were assessed in LTS (pts surviving ≥36 mo).
Results: 1171 pts were randomised to STRIDE (n=393), D (n=389) or
S (n=389); median (95% CI) duration of follow-up for OS analysis was
49.12 (46.95–50.17), 48.46 (46.82–49.81) and 47.31 (45.08–49.15) mo. e
OS HR (95% CI) for STRIDE vs S was 0.78 (0.67–0.92) and OS rates at 36
mo were for STRIDE 30.7% and for S 19.8%, which is consistent with pri-
mary results. e 48-mo OS rate was 25.2% for STRIDE and 15.1% forS.
sTRAEs (incl. death) occurred in 17.5% of pts treated with STRIDE and
9.6% treated with S; no new safety events were observed. D mono main-
tained non inferiority to S. Baseline demographics, clinical characteristics
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts70
and subsequent therapies, incl. pts rechallenged with T among the LTS
group in the STRIDE arm were consistent with FAS, suggesting that LTS
benet was not driven by any particular subgroup.
Conclusions: is updated analysis shows the sustained, long-term OS
benet of STRIDE vs S with unprecedented 3- and 4-year OS rates and
the longest follow-up to date in phase 3 studies in uHCC. e STRIDE
regimen maintained a tolerable yet dierentiated safety prole from other
uHCC therapies. ese results continue to support the benets of STRIDE
in a diverse global uHCC population.
Previously presented at ESMO World GI 2023, SO-15: 4-Year overall survival
update from the phase 3 HIMALAYA study of tremelimumab plus durvalumab
in unresectable hepatocellular carcinoma, Bruno Sangro etal. - Reused with
permission.
Funding: AstraZeneca
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
492
Real-world evidence in gastric and esophageal cancer: a
non-interventional study of rst-line (1L) nivolumab plus
chemotherapy or in combination with ipilimumab (the NIS
INGA study)
Alexander Stein1; Sylvie Lorenzen2; Jens Kisro3; Gertraud Stocker4;
Martin Herber5; Eyck von der Heyde6; Jens Uhlig7; Andreas Köhler8;
Henning Pelz9; Lothar Müller10; Stefan Kasper11; Florian Lordick4
1Hämatologisch-Onkologische Praxis Eppendorf Universitäres Cancer Center,
Hamburg, Deutschland
2Klinik und Poliklinik für Innere Medizin III, Klinikum rechts der Isar der TU
München, Munich, Deutschland
3Lübecker Onkologische Schwerpunktpraxis, Lübeck, Deutschland
4Medizinische Klinik II und Universitäres Krebszentrum Leipzig, Leipzig,
Deutschland
5Bristol Myers Squibb, Munich, Deutschland
6Onkologische Praxis am Raschplatz, Hannover, Deutschland
7Praxis Dr. Jens Uhlig, Naunhof, Deutschland
8Gemeinschaftspraxis für Hämatologie und Onkologie, Langen, Deutschland
9Onkologie Oenburg, Ambulantes Therapiezentrum für Hämatologie und
Onkologie, Oenburg, Deutschland
10Studienzentrum UnterEms, Leer, Deutschland
11Department of Medical Oncology, West German Cancer Center, University
Hospital Essen, Essen, Deutschland
Background: Nivolumab (NIVO) + chemotherapy (chemo) is approved
in the European Union (EU) for 1L treatment (Tx) of advanced gastric
cancer/gastroesophageal junction cancer/esophageal adenocarcinoma
(GC/GEJC/EAC) with programmed death ligand 1 (PD-L1) combined
positive score (CPS) ≥5. NIVO + chemo and NIVO + ipilimumab (IPI)
are approved in the EU for 1L Tx of advanced esophageal squamous cell
carcinoma (ESCC) with tumor cell (TC) PD-L1 ≥1%. However, as Tx
experience is primarily based on clinical trial data, real-world (RW) data
are urgently needed to validate the eectiveness, tolerability and qual-
ity of life (QoL) in a broader patient (pt) population. is prospective,
non-interventional, multicohort study will evaluate 1L NIVO + chemo
in advanced GC/GEJC/EAC and ESCC and 1L NIVO + IPI in advanced
ESCC in RW conditions in Germany.
Methods: Pts with previously untreated, HER2-negative, advanced or
metastatic GC/GEJC/EAC with PD-L1 CPS ≥5 who started Tx with NIVO
+ chemo (cohort [C] 1, n=350) and pts with previously untreated, unre-
sectable advanced, recurrent or metastatic ESCC with TC PD-L1 ≥1%
who started Tx with NIVO + chemo (C2, n=200) or NIVO + IPI (C3,
n=50) will be enrolled. Key exclusion criteria include concomitant or pre-
vious malignancy (≤3 years [y]) and current enrollment in an interven-
tional trial for GC/GEJC/EAC or ESCC. Pts will be followed for up to 3y
from enrollment. Assessments will be per routine local clinical practice.
Data will be collected on Tx initiation, then every 6 weeks until week 48,
then every 6 months until month 36. e primary endpoint is overall sur-
vival over 3y of follow-up. Secondary endpoints include ecacy, safety,
and pt-reported outcomes.
Results: Recruitment is ongoing in 79 centers in Germany. As of 21 July
2023, 100 pts are enrolled in C1. Of pts with available data, 79% are male
(n=95), mean age is 67y (range 45–88, n=95) and mean BMI is 25 kg/m2
(range 16–37, n=93). 88% of pts have ECOG PS of 0–1 (n=92) and
median of 2 metastases (range 0–9, n=21). Further baseline results will
be presented.
Discussion: Not available.
Conclusion: Not available.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
493
Multi-array miRNA approach and associated protein
expression proling for the development of predictive and
prognostic biomarkers in esophageal adenocarcinoma
Daniel Neureiter1; Christian Mayr2; Elen Neureiter1; Paul Winkelmann1;
Bettina Neumayer1; Eckhard Klieser1; Andrej Wagner3; Clemens Hufnagl4;
Klaus Emmanuel5; Josef Holzinger5; Oliver Koch5; Tobias Kiesslich2;
Martin Varga5
1Institute of Pathology, Paracelsus Medical University/University Hospital
Salzburg, Salzburg, Österreich
2Department of Internal Medicine I and Institute of Physiology and
Pathophysiology, Paracelsus Medical University/Salzburger Landeskliniken,
Salzburg, Österreich
3Department of Internal Medicine I, Paracelsus Medical University/Salzburger
Landeskliniken, Salzburg, Österreich
4Institute of Neurointervention, Department of Neurology, Paracelsus Medical
University/Salzburger Landeskliniken, Salzburg, Österreich
5Department of Surgery, Paracelsus Medical University/Salzburger
Landeskliniken, Salzburg, Österreich
Background: Esophageal adenocarcinoma (EA) may develop metastases
even in early stage (pT1) disease, but molecular biomarkers are lacking to
guide therapeutic decisions regarding surgical intensity (endoscopic/sur-
gical resection (ER/SR)). A multi-array miRNA study with consecutive in
silico analysis of dependent genes and in situ analysis of selected proteins
was chosen to detect possible biomarkers.
Methods: is retrospective analysis includes twenty cases of EA of the
distal esophagus/esophagocardial junction with ER without or SR with
lymph node metastasis (each n=10). e DNA of the FFPE material was
analysed using an advanced miRNA Human Card (spotted with 754
unique microRNAs) with consecutive in silico gene regulation and immu-
nohistochemical analysis of the associated proteins.
Result: e multi-array miRNA of the tumour sample with EA showed
an upregulation of 25 and a downregulation of 20 microRNAs, with the
highest dierences for the miRNAs miR-100-5p, miR-501-3p and miR-
576-5p (upregulation) and miR-150-3p, miR-190a-5p and miR-545-3p
(downregulation). e in silico analysis of these mirRNAs revealed the
downstream paired partners RDX-Rock2, DICER1-AGO2, YAF2-EZF6
and TET2-5HMC, which were signicantly dierentially expressed by
in-situ immunohistochemical staining.
Discussion: e molecular studies provide evidence for a specic miRNA
marker prole when comparing cases with localised and advanced EA. In
silico analysis revealed biologically relevant downstream gene and protein
targets, which were also signicantly dierentially expressed in-situ in
relation to the tumour stage of EA.
Conclusion: Taken together, these preclinical experimental biomarker
analyses may help to guide therapeutic decisions in cases with EA,
although validation in a larger cohort of EA is needed in the future.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 71
504
Prognostic implications of CRM-status in resected pancreatic
carcinoma – data obtained from the German cancer registry of
Baden-Württemberg
Jasmin Selina Schuhbaur1; Juliane Schütz1; Thomas Seuerlein1; Irina
Surovtsova2; Daria Kokh2; Gertrud Szotyori-Artz3; Claudia Winzler3;
Waldemar Uhl4; Andrea Tannapfel4; Philipp Morakis3
1Universitätsklinikum Ulm, Ulm, Deutschland
2Klinische Landeskrebsregisterstelle Baden-Württemberg, Stuttgart,
Deutschland
3Geschäftsstelle Qualitätskonferenzen bei der Klinischen Landesregisterstelle
Baden-Württemberg, Stuttgart, Deutschland
4Universitätsklinikum Bochum, Bochum, Deutschland
Background: Even if surgically resectable, pancreatic carcinoma still
accounts for one of the most unfavorable prognoses along malignancies. A
tumor-free resection margin (R0) bears prognostic meaning. However, in
pancreatic carcinoma dierent denitions of R0 exist. In order to explic-
itly dene the R0-status, the current German S3-guideline of pancreatic
carcinoma implemented the concept of circumferential resection margin
(CRM), which has long since been established for rectal carcinoma. While
the concept of CRM is plausible, current literature denes it heteroge-
neously and to date, there are few data documenting its prognostic mean-
ing in pancreatic carcinoma.
Methods: is analysis evaluates whether the CRM-status of resected
pancreatic carcinoma according to the current S3-guideline is in fact
prognostically relevant. erefore, patient data of the cancer registry of
Baden-Württemberg, Germany, have been analyzed including the years
of 2015 to 2020.
Result: We identied 1098 patients with resected pancreatic carcinoma
who met the inclusion criteria. We considered 340 patients R0 wide/CRM-
(distance of tumor cells from resection margin >1 mm), 410 patients R0
narrow/CRM+ (distance of tumor cells from resection margin ≤ 1 mm),
348 patients R1. R0 wide/CRM- status was associated with signicantly
increased 3-year-overall-survival in comparison to the other groups
(51,5%, 37,4% and 26,7% for R0 wide/CRM-, R0 narrow/CRM+ and R1,
respectively). Median progression free survival for R0 wide/CRM- was
prolonged in comparison to the other two groups as well.
Discussion: Even though it is not yet comprehensively well-established,
our data warrant for the routinely determination of CRM-status in
resected pancreatic carcinoma.
Conclusion: Our evaluation shows the prognostic importance of den-
ing the R-status according to the concept of CRM as implemented in the
German S3-guideline for pancreatic carcinoma.
Disclosure Statement: e authors declare no conict of interest.
517
Squamous esophageal carcinoma of the young female adult
Erik Wolniczak1; Christine March2; Roland Croner1; Daniel Medenwald3;
Frank Meyer1
1Dept. of General, Abdominal, Vascular and Transplant Surgery, University
Hospital, Magdeburg, Deutschland
2Dept. of Radiology and Nuclear Medicine, University Hospital, Magdeburg,
Deutschland
3Dept. of Radiation Therapy, University Hospital, Magdeburg, Deutschland
Background: Squamous esophageal carcinoma of the young adult can be
considered a rare tumor manifestation.
Aim: To illustrate the interesting and newsworthy case of a young female
patient with squamous esophageal cancer as a rare tumor manifestation
Methods: Scientic case report.
Result (case description):
Medical Hx:
- Current: Dysphagia
Diagnostic measures:
- Esophagogastroduodenoscopy: tumor lesion extending from 22 to 38
cm from row of teeth
- oracic/Abdominal CT scan
Decision-making (tumor board conference): Neoadjuvant radiochemo-
therapy (derived from CROSS protocol with 41.4 Gy and 5 cycles of che-
motherapy with Paclitaxel 50 mg/m² and Carboplatin AUC2 as well as
subsequent resection within the 6-weeks interval
Diagnosis: Squamous esophageal carcinoma (ypT3 pN0 M0 L0 V0 R0 G1)
of the middle and lower third (22-38 cm from row teeth)
Dierential diagnosis: Adeno-carcinoma of the esophagus, achalasia
Secondary diagnosis: - Mixed collagenosis
- Liver hemangiomas within the segment III and the right hepatic lobe
Surgical intervention: oracoabdominal esophagus resection with tho-
racic transposition of the stomach and esophagogastrostomy as well as
pyloromyotomy (in a dierent hospital)
Course: - Leukopenia (approximately 2.6 [SI]) during radiochemotherapy
- 3-yr-interval: Lobectomy of the right upper lobe
- Aer 5 yr: i.v.-port explantation due to infection with recurrent fever
attacks
Follow up: Adequate control investigations in a dierent hospital; cur-
rently, no hint for tumor recurrency
Conclusion: Despite the untypically young age, which does not exclude
completely the manifestation of a squamous esophageal carcinoma, the
same established treatment principles and modes are pursued (with
limited experiences due to the rare manifestation), which resulted in a
7-yr-survival.
Disclosure Statement: e authors declare no conict of interest.
550
The impact of inammation (chronic pancreatitis [Pan]) vs.
malignant tumor lesion (pancreatic head carcinoma [Ca])
including perioperative immune status on early postoperative
outcome in pylorus-preserving pancreatic head resection by
Traverso-Longmire (PPPHR)
Nikolas Scholz1; Max Grabowski1; Ronny Otto2; Roland Croner1;
Uwe Lodes3; Henry Ptok4; Frank Meyer1
1Dept. of General, Abdominal, Vascular and Transplant Surgery; University
Hospital, Magdeburg, Deutschland
2Otto-von-Guericke University, Institute of Quality Assurance in Operative
Medicine, Magdeburg, Deutschland
3Dept. of Anesthesiology and Intensive Care, Municipal Hospital (“AMEOS
Klinikum Schönebeck”), Schönebeck, Deutschland
4Dept. of General and Abdominal Surgery, Municipal Hospital
(“Ernst-von-Bergmann-Klinikum”), Potsdam, Deutschland
Background: Patients with chronic pancreatitis (Pan) & pancreas cancer
(Ca) undergo almost the same surgical intervention, namely, “pylorus-
preserving pancreatic head resection (PPPHR) by Traverso-Longmire.
Objective: To determine the inuence of di. diagnoses (Pan vs. Ca, both
treated with PPPD) & periop. immune status on early postop. outcome
aer PPPHR over a dened observation period.
Methods: All consecutive patients (pats.) who had undergone PPPHR
for Ca or Pan over a 15-year period were included in a computer-based
data le as part of this systematic retrospective single-center observa-
tional study of surgical quality assurance. e early postop. outcome was
assessed by postop. morbidity (in detail with general/specic complica-
tion rate) & 30-d hospital mortality. Parameters included in the SOFA
score as well as C-reactive protein (CRP), leukocytes (L) & procalcitonin
(PCT) among others served as markers of immune response.
Result: From 10/01/2002-30/09/2017, a total of n=238 pats. were included
(Ca signicantly older & hospitalized longer). Rates of general & specic
complications w/ 21.6% (Ca) vs. 15.6% (Pan) & 39.7% (Ca) vs. 42.7%
(Pan; p=0.224/p=0.623) as well as 30-d mortality diered only by trend:
2.6%(Ca) vs. 2.1%(Pan; p=0.796).
CRP was signicantly elevated (Ca/Pan: 181.74/229.32 μg/l [d2]; p=0.026
& 180.69/240.65 μg/L [d3]; p=0.041) - d1 vs. d0 w/o signif. dierence
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts72
(81.65/88.01 μg/L), also found again in CRP increase (“d2-d1”: 92.8/131.7
μg/L; p=0.034 / “d2-d0”: not shown).
In addition, CRP increases were signicantly higher in early complica-
tions (yes/no: 122.69/83.1 μg/L; p=0.044 [d2-d1] & p=0.001 [d2-d0; data
not shown]).
Conclusion: Cancer disease does not appear to be a signif. factor in
the overall outcome despite older age & longer postop. hospital stay of
patients does not signicantly impact morbidity & mortality in standard-
ized pancreatic head resection. As a marker for the occurrence of early
complications, only CRP provided a signif. indicating correlation.
Disclosure Statement: e authors declare no conict of interest.
605
Radioactive Seed guidance for the resection of
cholangiocellular carcinoma in cirrhotic patients – a report
oftwo cases
Noa Aegerter1; Philipp Sedlaczek1; Georg Henninger1;
Gabriel Fridolin Hess1; Alexander Tzankov2; Simone Muenst2;
Noemi Schmidt2; Christoph J. Zech2; Otto Kollmar1; Savas Soysal1
1Clarunis, Basel, Schweiz
2University Hospital Basel, Basel, Schweiz
Background: Detection of cholangiocellular and hepatocellular carcino-
mas can be challenging in both radiologic imaging and during surgical
resection. erefore, radioactive seed-guided resection of these tumors,
analogously to breast cancer, could be an interesting approach.
Methods: We present two cases of cirrhotic patients where this method of
tumor labelling was used.
Result: e rst case was a suspected hepatocellular carcinoma in a patient
with alcoholic liver cirrhosis. Although the targeted lesions had been ver-
ied by intraoperative ultrasound before non-anatomical resection, his-
tological examination of the specimen showed no tumor. ree months
later, tumor progression was seen in a scheduled MR imaging of the liver.
erefore, in a two-step approach, the patient underwent interventional
labelling of the tumor with a radioactive seed followed by open resection.
Complete removal of a combined hepatocellular-cholangiocarcinoma of
the liver in segment VII could be histologically conrmed.
In the second patients, which presented nine months aer the rst one,
seed-guided resection was recommended due to probable cirrhosis, local-
ization and the small size of the two suspicious lesions. In this second
patient, the lesions were pre-labelled with help of TACE and Lipiodol the
day before. Subsequently, two radioactive seeds were placed in the lesions,
and resection was performed successfully. A cholangiocarcinoma within
the cirrhotic liver was diagnosed histologically.
Discussion/Conclusion: is report emphasizes the diculties, which
surgeons and radiologists may face in tumor entities that are dicult to
identify both macroscopically, by palpation and intraoperative imaging
techniques. It also highlights the successful adaption of a procedure com-
monly used for breast cancer surgery for liver surgery.
Disclosure Statement: e authors declare no conict of interest.
609
The impact of liver regeneration on tumor growth – A patient-
derived HCC organoid mouse model
Fabian Haak1; Gabriel Fridolin Hess1; Philipp Sedlaczek1; Caner Ercan2;
Salvatore Piscuoglio2; Mairene Coto-Llerena2; Savas Soysal1;
Otto Kollmar1
1Clarunis, Basel, Schweiz
2University Hospital Basel, Basel, Schweiz
Background: Recurrence is a signicant problem following treatment for
Hepatocellular Carcinoma (HCC). It aects more than 70% of patients
receiving a surgical resection. Recurrence can arise from undetected
micrometastasis (multicentric tumor) or “de novo” cancer. Clinical and
experimental studies suggest that liver regeneration ensuing surgical
resection may activate occult micro-metastasis leading to tumor recur-
rence. Here, we aim to establish an in vivo model to understand the
impact of liver regeneration on HCC tumor growth.
Methods: Patient Derived Organoids (PDOs) were generated from HCC
tissue. HCC-PDO organoids have been proved to retain the histopatho-
logical characteristic of the original tumor. Aer a laparotomy, HCC-PDO
were implanted in the liver of NOD Scid gamma mice. Experimental
group undergo a re-laparotomy and 30% or 70% hepatectomy while con-
trol group only receives a re-laparotomy. Tumor growth was monitored
by ultrasound until the end-point of the experiment. Healthy and tumor
tissue were characterized using immunohistochemistry.
Result: e HCC-PDOs implantation process has been rened and opti-
mized regarding scheme of anesthesia, volume and speed of injection.
We have successfully performed the implantation of 2 HCC-PDO lines.
Tumors obtained from the orthotopic models maintain the histopatho-
logical characteristic of the initial tumor. Preliminary results from animals
that received resections aer implantation, showed an increase in tumor
growth compared to control.
Discussion/Conclusion: Preliminary data shows an increased tumor
growth rate in our resection groups compared to control groups. Our
established orthotopic xenogra model can help understand the molecu-
lar basis of HCC recurrence aer surgery. erefore, this model may pro-
vide the basis for future projects for specic drug therapy before or aer
liver resection to inhibit tumor growth and favour regeneration.
Disclosure Statement: e authors declare no conict of interest.
612
Surgical Strategies for Hepatocellular Carcinoma in Cirrhotic
Patients: Anatomic versus Non-Anatomic Resection
Jasmin Zeindler1; Gabriel Fridolin Hess1; Maximilian von Heesen2; Philipp
Sedlaczek1; Noa Aegerter1; Cornelia Reber3; Andreas Michael Schmitt4;
Simone Muenst5; Martin Bolli1; Savas Soysal1; Otto Kollmar1
1Clarunis, Basel, Schweiz
2University Hospital Göttingen, Göttingen, Deutschland
3University of Basel, Basel, Schweiz
4The Royal Marsden NHS Foundation Trust, London, United Kingdom
5University Hospital Basel, Basel, Schweiz
Background: e incidence of hepatocellular carcinoma (HCC) is
increasing in the western world over the past decades. As liver resection
represents one of the most ecient treatment options, advantages of ana-
tomic (ALR) versus non-anatomic liver resection (NALR) show a lack of
consistent evidence. erefore, the aim of this study was to investigate
complications and survival rates aer both resection types.
Methods: is is a retrospective and prospective multicentre cohort study.
We included all patients undergoing liver resection for HCC between
2009 and 2020 from 3 specialised centres in Switzerland and Germany.
Complication and survival rates aer ALR versus NALR were analysed
using uni- and multivariate Cox regression models.
Result: 298 patients were included. 164/298 patients (55%) underwent
ALR. Signicantly more patients with cirrhosis received NALR (n =
94/134; p<0.001). Complications according to the Clavien Dindo classi-
cation were signicantly more frequent in the NALR group (p<0.001).
Liver failure occurred in 13% aer ALR versus 8% aer NALR (p<0.215).
Uni- and multivariate cox regression models showed no signicant dier-
ences between the groups for recurrence free survival and overall survival.
Furthermore, cirrhosis had no signicant impact on overall survival and
recurrence free survival.
Discussion/Conclusion: No signicant dierences on recurrence free
survival and overall survival rates could be observed. Postoperative com-
plications were signicantly less frequent in the ALR group while liver
specic complications were comparable between both groups. Subgroup
analysis showed no signicant inuence of cirrhosis on the postoperative
outcome of these patients.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 73
614
TACE Treatment Outcomes for Hepatocellular Carcinoma: A
Retrospective Cohort Analysis from a Swiss Tertiary Center
Fabian Haak1; Noa Aegerter1; Philipp Sedlaczek1; Tobias Karli2; Gabriel
Fridolin Hess1; Jasmin Zeindler1; Martin Takes3; Christoph J. Zech3;
Otto Kollmar1; Savas Soysal1
1Clarunis, Basel, Schweiz
2University of Basel, Basel, Schweiz
3University Hospital Basel, Basel, Schweiz
Background: International guidelines recommend transarterial chemo-
embolization (TACE) for intermediate-stage Hepatocellular carcinoma
(HCC). However, it is used outside these recommendations and has
proven to be benecial in prolonging survival. Since the role of TACE
outside BCLC stage B is unclear, the present study analyzed the results of
TACE performed at a tertiary center in Switzerland for dierent treatment
groups and aims to highlight the treatment outcomes in these groups.
Methods: is retrospective cohort study includes 101 HCC patients
undergoing TACE at our center. Tumor specications (size, localiza-
tion, number of lesions) and patient characteristics (scores for cirrho-
sis, Hepatoma arterial-embolization prognostic score) were included in
the analysis. Kaplan Meier survival curves were calculated for Barcelona
Center for Liver Cancer (BCLC) subgroups.
Result: Aer TACE median survival was 28.1 months for BCLC 0, 31.5
months for BCLC A, 20.5 months for BCLC B, 10.8 for for BCLC C and 7.5
months for BCLC D. Lesion size larger than 55mm was negatively associ-
ated with survival (HR 2.8, 95% CI 1.15 – 6.78). Complications occurred
aer TACE procedures: Clavien-Dindo I + II = 30. Clavien-Dindo ≥3 = 2.
Discussion/Conclusion: TACE was performed in a substantial part of our
cohort outside of routinely used treatment guidelines. e combination
of the survival data and complication rate in these patients suggest that
it was a safe and benecial strategy compared to systemic therapy or best
supportive care, which would be the suggested treatment according to the
guidelines. Furthermore, our data shows that in our cohort the survival
benet associated with TACE was restricted to the patients with a lesion
size smaller than 55mm.
Disclosure Statement: e authors declare no conict of interest.
621
Coincidence of three carcinomas (Ca) of the gastrointestinal
(GI) tract at dierent segments
Yelyzaveta Zaporozhchenko1; Christine March2; Robert Jänsch3;
Ulrich Vorwerk4; Daniel Medenwald5; Dörthe Jechorek6; Roland Croner1;
Frank Meyer1
1Dept. of General, Abdominal, Vascular and Transplant Surgery; University
Hospital, Magdeburg, Deutschland
2Dept. of Radiology and Nuclear Medicine, University Hospital, Magdeburg,
Deutschland
3Dept. of Gastroenterology, Hepatology and Infectious Diseases; University
Hospital, Magdeburg, Deutschland
4Dept. of Otorhinolaryngology, University Hospital, Magdeburg, Deutschland
5Dept. of Radiation Therapy, University Hospital, Magdeburg, Deutschland
6Institute of Pathology, University Hospital, Magdeburg, Deutschland
Background: Coincidence of neoplastic lesions can be considered an
extremely interesting subgroup of malignant tumor (Tu) patients.
Method: Scientic case report
Result (Case):
- Medical Hx: * 69-years old male patient w/ 1) colon Ca; 2) status aer
ESD of early gastric Ca (intestinal type at prepyloric site) pT1b(sm1)
L1V0Pn0R0G1; MMRp status; HER2/new status, negative; 3) status
aer squamous cell Ca of the le oropharynx cT4cN2bcM0 w/ pri-
mary radiochemoTx
- Clinical ndings: Patient in age-related general & nutritional status
- Diagnostic: * Lab parameters: CrP, 172 mg/L / white blood cell count,
within normal range
* Colonoscopy/Histology (Bx), adeno-Ca of the sigmoid colon,
70×42×14mm in size, lymphangiosis carcinomatosa
- Dx: 3 Ca of the GI tract with a recently diagnosed adeno-Ca of the
sigmoideo-rectal junction
- Decision-making: Indication for surgical intervention
- erapy: Anterior rectum resection w/ TME, lymphadenectomy &
descendorectostomy + protective loop ileostoma
- Histopathology: pT3pN1b(2/28)L1V0Pn0R0
- Postop. course: Intensive care for 24 h; on the 6th/12th postop. d: surgi-
cal re-intervention (anastomotic resection & new creation); thereaer,
improvement of clinical nding & lab parameters
- Complications: Anast. insuciency, wound seroma
- Proceeding: Antiseptic wound care (upper pole) in an outpatient clin-
ic-setting, stoma care, postop. chemotherapy (“CAPOX“) according to
Tu board conferences recommendation, adequate follow up-investiga-
tions of the early gastric & oropharynx Ca
- Long-term outcome: Follow up-time periods of 45, 42 & 39 months,
resp., depending on Tu Dx showing recurrent Tu growth of orophar-
ynx Ca aer 40 months w/ subsequent radiation
Conclusion: From the extremely rare case example of a 3-fold Tu man-
ifestation with Cas at the same organ (GI tract), a substantial familiary
burden & a considerable individually increased risk constellation with
regard to epithelial &/or GI tract-associated tumorigenesis (also car-
cinogenesis) can be derived.
Disclosure Statement: e authors declare no conict of interest.
645
Identication of acquired chemoresistance mechanisms
in patient-derived organoid models of pancreatic
adenocarcinoma
Katharina Wansch1; Christopher Neumann1; Florian Dölvers1;
Sebastian Stintzing1; Ulrich Keilholz2; Uwe Pelzer1
1Charite Campus Mitte, Freie Universität Berlin, Humboldt Universität zu Berlin,
Berlin Institute of Health, Department of Hematology, Oncology and Cancer
Immunology, Berlin, Deutschland
2Charité Comprehensive Cancer Center, Charité Universitätsmedizin Berlin,
Berlin, Deutschland
Background: Pancreatic adenocarcinoma (PDAC) is one of the deadliest
types of cancers with 80% of patients relapsing within the rst ve years.
e poor prognosis results from limited treatment options and a high
level of resistance to chemotherapy.
To address these issues, patient-derived organoids (PDOs) have been eval-
uated as predictive plat-forms for treatment response in PDAC. Currently,
PDO drug response is measured at a single time point only. To gain a more
comprehensive understanding, we aim at developing a dynamic predictive
platform and insight into functional changes leading to chemotherapeutic
resistance.
Methods: We established PDOs of treatment-naïve patients and charac-
terized them histologically and genomically. Moreover, PDO response
to common chemotherapeutics was measured. Cultures were exposed
to six cycles of chemotherapy, closely mimicking the clinical situation
of patients, to induce resistance. Mechanisms of resistance are identi-
ed by analyzing the PDO transcriptome and proteome before and aer
chemotherapy.
Result: Pharmacotyping 10 PDO-cultures, a heterogeneous treat-
ment response was observed, representing intertumoral heterogeneity.
Moreover, we observed our models to become more chemoresistant aer
cyclic treatments. Induction of resistance was successful with models
showing a dierential response toward chemotherapy aer the treatment.
Discussion: Our results demonstrate that resistance induction in PDO
models is feasible. us, the predictive power of correlating in-vitro data
to clinical patient outcome will present a very promising tool for future
personalized medicine approaches.
Conclusion: e objective of our research project is the development of
a dynamic prediction platform for the iden-tication of chemotherapy
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts74
resistance in pancreatic adenocarcinoma. is dynamic predictive plat-
form may allow a deeper understanding of the tumors physiology, bet-
ter treatment choices and enhance the prognosis of these patients in the
long-term.
Disclosure Statement: e authors declare no conict of interest.
649
Investigation of dierential tumor physiology in
primary tumor and metastatic sites in pancreatic ductal
adenocarcinoma
Florian Dölvers1; Christopher Neumann1; Katharina Wansch1;
Sebastian Stintzing1; Ulrich Keilholz2; Uwe Pelzer1
1Charite Campus Mitte, Freie Universität Berlin, Humboldt Universität zu Berlin,
Berlin Institute of Health, Department of Hematology, Oncology and Cancer
Immunology, Berlin, Deutschland
2Charité Comprehensive Cancer Center, Charité Universitätsmedizin Berlin,
Berlin, Deutschland
Background: Pancreatic ductal adenocarcinoma (PDAC) is a major con-
tributor to cancer-related mortalities around the globe. It is estimated that
50% of patients are already in an advanced metastatic stage upon diagno-
sis. Unfortunately, the 5 year survival rate in the metastatic stage is 2%.
Based on the localization of metastases, dierent survival rates have been
clinically observed. Consequently, gaining a deeper comprehension of the
individual attributes of the primary tumor and its corresponding metasta-
ses is crucial in devising future personalized therapeutic strategies.
Methods: is project examines the dierential tumor physiology
between primary and synchronous metastases of PDAC using patient-
derived organoids (PDO). PDO models are being veried and charac-
terized immunohistochemically and genomically by the Cancer Hotspot
Panel. Drug sensitivities for known therapeutic regimens for PDAC are
being measured using the CellTiter-Glo® Luminescent Cell Viability Assay
and correlated to the CT-scans of patients using RECIST criteria. Further
multi-omics analyses are currently ongoing examining dierences in
transcriptome and proteome.
Result: PDO models from a total of four patients from the primary
and synchronous metastatic site have been established. Dierential
CDX2 expression in immunohistochemistry as well as dierent therapy
responses have been observed.
Discussion: Dierences in transcriptome and proteome could provide
targets to include dierential pharmacotypes for personalized treatment
in the future.
Conclusion: e results of this study could facilitate new therapeutic
approaches for metastatic PDAC in a personalized therapy approach.
Disclosure Statement: e authors declare no conict of interest.
653
Development of a High-Throughput Assay for Functionally
Proling Individual Tumors to Direct Clinical Decision Making
Sushmitha Sankarasubramanian1; Gerrit Erdmann2; Przemyslaw Dudys2;
Christian Pilarsky3; Christian Regenbrecht1,4,5; Christoph Reinhard1,4;
Lena Wedeken1
1CELLphenomics GmbH, Berlin, Deutschland
2NMI TT GmbH, Berlin, Deutschland
3Universitätsklinikum Erlangen, Erlangen, Deutschland
4ASC Oncology GmbH, Berlin, Deutschland
5Institute for Pathology, Universitätsklinikum Göttingen, Göttingen,
Deutschland
Background: Despite all scientic eort, pancreatic cancer remains a clin-
ically challenging disease. With systemic therapies oen being ineective,
more targeted treatment options are clinically needed. Response to these
therapies has high inter-patient variability, and there is currently a lack of
reliable biomarkers correctly predicting treatment outcomes.
Methods: We used patient-derived 3D pancreatic cancer models and
rened assay conditions to enable the high-throughput drug screening.
We combined this approach with DigiWest, a targeted proteomics tech-
nology, allowing for the assessment of basal protein expression levels and
pathway activities across dierent models. Integration of dierential pro-
tein expression levels with therapy sensitivity data was achieved through
robust functional pathway analysis.
Result: Our approach facilitates extensive high-content screenings,
involving an array of chemotherapeutic agents and targeted therapeutics.
Drug sensitivity proles were identied on individual basis. Employing
a comprehensive panel of over 233 (phospho-)antibodies, spanning the
MAPK/ERK/RAS, PI3K/AKT, and mTOR, cell cycle, proliferation, apop-
tosis, and DNA damage repair pathway on dierent models, we gained
insights into the functional aspects of these pathways in individual models.
Discussion: Combination of PD3D® models with DigiWest functional
pathway analysis is a potent toolkit for unraveling the molecular under-
pinnings of varied drug responses. is collaborative approach holds the
potential to deepen our insights into drug resistance and sensitivity, poten-
tially uncovering distinctive molecular markers with clinical relevance.
Conclusion: High-throughput drug screening using PD3D micro tumors
together with DigiWest analysis poses a robust instrument for decipher-
ing the intricate mechanisms dictating divergent responses to therapeutic
interventions.
Disclosure Statement: e authors declare the following: e authors declare the
following: CRAR is shareholder at CELLphenomics GmbH, a company oering
drug screens on organoid models, and ASC Oncology GmbH, a company involved
in patient specic therapy prediction.
690
Investigating patient-derived-organoids as a prediction
platform for clinical response in cholangiocarcinoma
A. Kühn*1, C.C.M. Neumann*1, K. Wansch1, F. Dölvers1, J. Ihlow2,
M.Dragomir2, S. Stintzing1, U. Keilholz3, U. Pelzer1
*both authors contributed equally
1Charite Campus Mitte, Freie Universität Berlin, Humboldt Universität zu Berlin,
Berlin Institute of Health, Department of Hematology, Oncology and Cancer
Immunology
2Department of Pathology, Charité-Universitätsmedizin Berlin, Freie Universität
Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Germany
3Charité Comprehensive Cancer Center, Charité Universitätsmedizin Berlin
Background: Cholangiocarcinoma (CCC) is an epithelial neoplasia of the
hepatobiliary system. 60-70% of patients are diagnosed at an advanced
stage and can only be oered a palliative therapy. ose patients, who are
eligible for surgical resection, are at 70% risk of recurrence within the rst
5 years. Recently, molecular targeted therapies have proven to be very
successful. However about 60% of patients do not show any targetable
mutations.
Methods: A total of 25 patient-derived organoids (PDOs) are being
isolated from metastatic or primary lesions of intrahepatic (iCCC) and
extrahepatic (eCCC) CCC. e models are characterized by histologi-
cal, immunohistochemical and genetic analyses. e PDOs will then be
pharmacotyped and classied based on their response using a statistical
or pharmacokinetic classication method. e in-vivo therapy response
of the donor patients will be evaluated radiologically and correlated to the
in-vitro classication of the corresponding PDOs.
Result: CCC PDOs were isolated from over 10 tumor samples, includ-
ing resection samples and tissue biopsies. We observed a success rate of
establishing cultures of at least 50%. Further PDO characterizations are
ongoing and models are being classied into resistant and sensitive.
Discussion: PDOs as prediction models have been poorly studied in CCC
research to date. Hogenson et al. recently correctly predicted the clinical
response of patients in one of two cases using two established CCC PDOs.
In 2021 Wang et al. also reported concordance between the response of an
eCCC as well as iCCC PDO with the clinical response of donor patients.
Yet, we propose a bigger and more comprehensive study including wild-
type PDOs and PDOs with IDH1/2- as well as FGFR2-alterations.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 75
Conclusion: is work aims at establishing PDOs for therapy prediction
in CCC patients and in their potential in precision medicine. Patients
without targetable mutations could particularly benet from such models
with future high-throughput drug-screening being implemented.
Disclosure Statement: e authors declare no conict of interest.
708
Outcomes by antibiotic use in participants with advanced
biliary tract cancer treated with durvalumab
Uwe Pelzer1; Aiwu R He2; Benjamin Tan3; Thatthan Suksombooncharoen4;
Hidenori Takahashi5; Ming-Huang Chen6; Vikas Ostwal7; Sang Cheul Oh8;
Emel Sezer9; Piotr Potemski10; Kun-Ming Rau11; Ekaphop Sirachainan12;
Junhe LI13; Jean-Frédéric Blanc14; Gordon Cohen15;
Magdalena Żotkiewicz16; Nana Rokutanda15; Do-Youn Oh17
1Charité-Universitätsmedizin Berlin, Division of Hematology, Oncology and
Tumor Immunology, Berlin, Deutschland
2Georgetown University, Division of Hematology and Oncology, Lombardi
Comprehensive Cancer Center, Washington DC, USA
3Washington University School of Medicine, Department of Medicine, St. Louis,
USA
4Chiang Mai University, Department of Internal Medicine, Faculty of Medicine,
Chiang Mai, Thailand
5Osaka International Cancer Institute, Department of Gastroenterological
Surgery, Osaka, Japan
6Taipei Veterans General Hospital, Department of Oncology, Taipei City, Taiwan
7Tata Memorial Hospital, Mumbai, Indien
8College of Medicine, Korea University, Division of Hematology and Oncology,
Department of Internal Medicine, Seoul, Republik Korea
9Mersin University Medical Faculty, Department of Oncology, Mersin, Türkei
10Medical University of Lodz, Copernicus Memorial Hospital, Department of
Cancer Chemotherapy, Lodz, Polen
11E-Da Cancer Hospital, Department of Hematology-Oncology, College of
Medicine, I-Shou University, Kaohsiung, Taiwan
12Ramathibodi Hospital, Mahidol University, Division of Medical Oncology,
Department of Medicine, Faculty of Medicine, Bangkok, Thailand
13The First Aliated Hospital of Nanchang University, Department of Oncology,
Nanchang, China, VR
14Hôpital Haut-Lévêque, Department of Hepato-gastroenterology and Digestive
Oncology, Bordeaux, Frankreich
15AstraZeneca, Oncology R&D, Late-Stage Development, Gaithersburg, USA
16AstraZeneca, Oncology Biometrics, Late Oncology Statistics, Warsaw, Polen
17Seoul National University Hospital, Cancer Research Institute, Seoul National
University College of Medicine, Division of Medical Oncology, Department of
Internal Medicine, Seoul, Republik Korea
Background: TOPAZ-1 is a double-blind, Phase 3 study of durvalumab
(D), an immune checkpoint inhibitor (ICI), + gemcitabine and cisplatin
(GC) in pts with advanced biliary tract cancer (BTC). D + GC improved
OS in pts with advanced BTC versus placebo (PBO) + GC (Oh et al. NEJM
Evid 2022). Use of antibiotics during ICI treatment has been correlated
with poorer OS and PFS (Jiang et al. Front Oncol 2022).
Methods: Pts were randomized 1:1 to receive D (1500 mg) or PBO on Day
1 every 3 weeks (Q3W), + G (1000 mg/m2) and C (25 mg/m2) on Days 1
and 8 Q3W, for ≤8 cycles, followed by D or PBO monotherapy Q4W. is
exploratory subgroup analysis assessed OS and PFS by systemic antibiotic
use during the study (≥1 dose 14 days before rst D/PBO dose to 14 days
aer last D/PBO dose). HRs were estimated using an unstratied Cox pro-
portional hazards model, adjusting for disease status (initially unresect-
able or recurrent) and primary tumor location. Data cut-o at primary
analysis was Aug 11, 2021.
Result: e number (%) of pts using antibiotics (D + GC, 167/341
[49.0%]; PBO + GC, 167/344 [48.5%]) was similar between both arms. In
the D + GC arm, median OS (95% CI) was similar regardless of antibiotics
use: 12.6 (9.7–14.8) months in pts with antibiotics use vs 13.0 (10.8–14.7)
months in pts without. In the PBO + GC arm, median OS (95% CI) was
10.3 (8.7–12.5) in pts with antibiotics use vs 12.1 (11.0–13.8) in pts with-
out. OS HRs (95% CI) in D + GC vs PBO + GC were 0.78 (0.59–1.02) in
pts with antibiotics and 0.81 (0.62–1.07) in pts without. Median PFS (95%
CI) was 7.3 (6.5–7.7) months in pts with antibiotics use vs 7.2 (5.9–7.4)
months in pts without in the D + GC arm and 5.7 (5.4–6.6) months vs
6.1 (5.6–7.3) months, respectively, in the PBO + GC arm (Table). PFS
HRs (95% CI) were 0.70 (0.55–0.89) in pts with antibiotics use and 0.82
(0.65–1.03) in pts without.
Conclusion: No meaningful dierence was found in OS or PFS for pts
who received antibiotics compared with those who did not. ese results
support that people receiving D may be treated with antibiotics when
indicated.
Clinical Trial identication: NCT03875235
Funding: AstraZeneca
Disclosure Statement: e authors declare the following: AstraZeneca Funding
765
Rare inammatory and neoplastic lesions of the appendix
vermiformis - spectrum and clinical courses
in a representative case series
Christoph Paasch1; Claus Schildberg1; Roland Croner2; Frank Meyer2
1Dept. of General and Abdominal Surgery, University Hospital, Brandenburg,
Deutschland
2Dept. of General, Abdominal, Vascular and Transplant Surgery, University
Hospital, Magdeburg, Deutschland
Background: In addition to the acute inammation of appendix vermi-
formis, there are numerous appendix-related dierential diagnoses, which
i) can occur in daily clinical practice, ii) can mimic acute appendicitis but
they are usually dierent w/ regard to its etiopathogenesis, clinical appear-
ance & therapeutic decision-making, & as well as iii) require adequate
diagnostic & therapeutic management.
Methods: Representative scientic case series (design) w/ rare appendix
vermiformis-associated manifestations of diverse diagnoses (AVAM) to
reect daily clinical, in particular, surgical practice.
Result (corner points):
- e spectrum of AVAM is broad - all specic diagnoses & entities can
mimic acute appendicitis w/ regard to clinical symptomatology, labo-
ratory parameter prole & (partially) imaging.
- AVAM are dominated by inammatory & neoplastic entities.
- Specic attention is focussed onto chronic appendicitis, appendicop-
athy, mucinous appendix carcinoma, acute appendicitis in a femoral
or inguinal hernia, twisted “appendix epiploica, single metastasis of
gastric cancer at the appendix, appendagitis epiploica, subhepatic
appendicitis, perityphlitic inltration, neuroendocrinetumor lesion of
the appendix, pseudomyxoma peritonei in case of mucinous appendix
carcinoma.
- All determined entities required surgical intervention only in one
exceptional case, conservative therapeutic approach was imaginable in
denitive diagnosis-nding.
Conclusion: AVAM can have diverse origin and comprise various entities.
e competent, consequent, correct & early diagnosis-nding appears
decisive w/ regard to therapy, early postop. course & (in case of malignant
diseases) prognosis.
Histopathology & close interdisciplinary cooperation are - due to AVAM
rareness - a substantial prediction for a timely diagnosis-nding, prompt
therapeutic decision-making & practical realization as well as - if neces-
sary - subsequent therapeutic steps, possibly using variable modes.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts76
767
The clinical importance of the host anti-tumor reaction
patterns in regional tumor draining lymph nodes in patients
with locally advanced resectable gastric cancer: a systematic
review and meta-analysis
Elze Budginaite1; Maximilian Kloft1,2; Sander M.J. van Kuijk3; Pedro Canão4;
Kooreman Loes1; Pennings Alexander5; Derek R Magee6; Henry Woodru7;
Heike Grabsch1,8
1Department of Pathology, GROW School for Oncology and Reproduction,
Maastricht University Medical Center+, Maastricht, Niederlande
2Department of Internal Medicine, Justus-Liebig-University, Gießen,
Deutschland
3Department of Clinical Epidemiology and Medical Technology Assessment,
Maastricht University Medical Center+, Maastricht, Niederlande
4Anatomical Pathology Department, Centro Hospitalar Universitário de São
João, Porto, Portugal
5Department of Surgery, GROW School for Oncology and Reproduction,
Maastricht University Medical Center+, Maastricht, Niederlande
6School of Computing, University of Leeds, Leeds, United Kingdom
7The D-Lab: Decision Support for Precision Medicine, GROW School for
Oncology and Developmental Biology, Maastricht University Medical Center+,
Maastricht, Niederlande
8Pathology & Data Analytics, Leeds Institute of Medical Research at St Jamess,
University of Leeds, Leeds, United Kingdom
Background: e status of regional tumor draining lymph nodes (LN) is
crucial for prognostic evaluation in gastric cancer (GC) patients1. Changes
in LN microarchitecture, such as follicular hyperplasia (FH), sinus histio-
cytosis (SH), or paracortical hyperplasia (PH), may be triggered by the
anti-tumor immune response2. However, the prognostic value of these
changes in GC patients is unclear.
Methods: A systematic search in multiple databases was conducted to
identify studies on the prognostic value of microarchitecture changes
in regional tumor-negative and tumor-positive LNs measured on histo-
pathological slides. Since the number of GC publications was very limited,
the search was subsequently expanded to include junctional and esopha-
geal cancer (EC).
Result: A total of 28 articles (17 GC, 11 EC) met the inclusion criteria,
analyzing 26,503 LNs from 3,711 GC and 1,912 EC patients. e stud-
ies described eight dierent types of LN microarchitecture changes,
categorized into three patterns: hyperplasia (SH, FH, PH), cell-specic
inltration (dendritic cells, T-cells, neutrophils, macrophages), and dier-
ential gene expression. Meta-analysis of ve GC studies showed a positive
association between SH in tumor-negative LNs and better 5-year overall
survival. Pooled risk ratios for all LNs showed increased 5-year overall
survival for presence of SH and PH.
Discussion: is systematic review suggests that SH and PH in regional
tumor-negative LNs may provide additional prognostic information for
gastric and esophageal cancer patients.
Conclusion: Further studies are needed to better understand LN reaction
patterns and explore the impact of chemotherapy treatment and immu-
notherapy ecacy.
References:
1 Smyth EC, Nilsson M, Grabsch HI, van Grieken NC, Lordick F. Gastric cancer.
Lancet. 2020 Aug 29;396(10251): 635–648.
2 Vollmer E, Krieg V, Shimamoto F, Grundmann E. Reaction patterns of lymph
nodes in the development and spread of cancer. Curr Top Pathol. 1991. 84
(Pt 2):1–34.
is research was funded by the Hanarth Fonds.
Disclosure Statement: e authors declare no conict of interest.
785
Clinical relevance of morphological heterogeneity
in pancreatic cancer
Aslihan Yavas; Lena Häberle; Irene Esposito
Institut für Pathologie, Universitätsklinikum Düsseldorf, Düsseldorf,
Deutschland
Background: Pancreatic ductal adenocarcinoma (PDAC) is a hetero-
geneous disease. However, the value of histomorphological subtyping
remains unknown. e aim of this study is to categorize PDACs according
to tumor morphology and investigate its relationship with clinicopatho-
logical ndings.
Methods: Using a detailed histomorphological analysis based on the
presence of a special histologic component in >30% of the tumor, 164
PDACs were classied as conventional, complex with small solid nests or
large solid sheets, papillary and cribriform. PDAC variants, presence of
clear cells (>30%) and pleomorphic single cells were assessed. One-way
ANOVA, Kruskal-Wallis, Mann-Whitney U tests and Kaplan-Meier sur-
vival curves were used for statistical analyses.
Result: PDAC variants accounted for 13% of the cases (8% adenosqua-
mous, 4% undierentiated, 1% micropapillary). While 35% of cases were
classied as conventional PDACs, 36% had complex, 14% papillary and
2% cribriform patterns. All complex PDACs were grade 3 (p<0.05) and a
higher proportion of them had pleomorphic single cells (61%) and clear
cells (27%) (p<0.05), compared to conventional and papillary tumors
Papillary PDACs revealed longer overall survival (median 30.2 months)
than conventional, complex and cribriform subtypes (median 19.3, 16 and
13 months, respectively), with signicant dierence between complex and
papillary PDACs (p<0.05).
Discussion: Our results conrm the highly heterogeneous nature of
PDAC and show prognostic relevance. PDACs with complex morphology
revealing cribriform structures, abortive glands, small solid nests or large
solid sheets, tend to be more aggressive and with higher WHO grades, as
opposed to conventional, papillary and pure cribriform PDACs.
Conclusion: Morphological classication is useful for better understand-
ing the characteristics of PDAC and predicting clinical outcome. Further
analyses are currently elucidating the association between molecular and
morphological subtypes of PDAC.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 77
854
Hep-Reg Trial An international retrospective/prospective
multicentre registry collecting data on patients treated with
SBRT for Hepatocellular CARCINOMA
Danny Jazmati1; Judit Boda-Heggemann2; Julien Merta3;
Ricarda von Krüchten4; Eleni Gkika5; Andrea Wittig-Sauerwein6;
Christiane Matuschek7; Wilfried Budach7; Oliver Blanck8; David Krug9;
Thomas Brunner10
1Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
2Universitätsklinik Mannheim, Mannheim, Deutschland
3Westdeutsches Protonentherapiezentrum Essen (WPE), Essen, Deutschland
4Uniklinik Freiburg - Klinik für Radiologie - Schnittbildzentrum (SBZ), Freiburg
im Breisgau, Deutschland
5Universitätsklinikum Freiburg -Klinik für Strahlenheilkunde, Freiburg im
Breisgau, Deutschland
6Strahlentherapie - Uniklinikum Würzburg, Würzburg, Deutschland
7Strahlentherapie und Radioonkologie, Düsseldorf, Deutschland
8Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für
Strahlentherapie und Radioonkologie, Kiel, Deutschland
9Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für
Strahlentherapie und Radioonkologie, Kiel, Deutschland
10Universitätsklinikum Graz, Graz, Österreich
Purpose: Although stereotactic body radiotherapy (SBRT) is an eective
non-invasive therapeutic modality for inoperable hepatocellular carci-
noma (HCC), critical parameters such as optimal timing, dose, and target
volume selection within a multi-modality treatment context remain unde-
ned due to the limited sample size and heterogeneity in previous inves-
tigations. is retrospective and prospective registry study is designed to
collect clinical and therapeutic data from patients diagnosed with pri-
mary or locally recurring non-metastatic HCC who are undergoing or
have completed SBRT treatment. By creating a robust data repository, the
HepReg study registry aims to provide the foundation for future clinical
trials and the development of evidence-based treatment guidelines.
Methods: Both retrospective and prospective registry studies consider the
following inclusion criteria:
Treatment of HCC with SBRT.
Age ≥ 18 years.
Informed consent of the patient, demonstrated by the existence of a
written consent form for data submission to the registry.
Results: e principal objective of the HepReg register is to compile a
comprehensive multicentre, multiplatform dataset, encompassing treat-
ment methodologies and patient outcomes. Specically, the focus is on
delineating the ecacy of local and intrahepatic control of irradiated
lesions, systemic disease control, overall survival, and progression pat-
terns. e study further strives to elucidate any correlations between
SBRT dose, administration and recurrence incidence. In addition, acute
and late eect data will be systematically recorded and analyzed.
Conclusions: e data collection process for both the retrospective and
prospective components of the study is slated to begin in October 2023.
e retrospective data collection is projected to conclude by October 2024,
while the prospective component, including an additional 24 months of
post-treatment data collection to record late toxicity and ecacy data, is
anticipated to nish by March 2027.
Disclosure Statement: e authors declare no conict of interest.
856
Perioperative or adjuvant nab-paclitaxel plus gemcitabine
for resectable pancreatic cancer: Quality of life results of the
randomized phase II AIO-NEONAX trial
Thomas J. Ettrich1; Sina Buchholz1; Waldemar Uhl2; Marko Kornmann3;
Hana Algül4; Helmut Friess5; Alexander-Otto König6; Michael Ghadimi7;
Eike Gallmeier8; Detlef K. Bartsch9; Manfred P. Lutz10; Ralf Metzger11;
Kai Wille12; Bertold Gerdes13; Carl C. Schimanski14; Florian Graupe15;
Volker Kunzmann16; Ingo Klein17; Michael Geissler18; Ludger Staib19;
Dirk Waldschmidt20; Christiane Bruns21; Uwe A. Wittel22;
Stefan Fichtner-Feigl22; Severin Daum23; Andreas Berger1;
Angelika Kestler1; Jasmin Schuhbaur1; Juliane Schütz1; Lukas Perkhofer1;
Anke Reinacher-Schick24; Thomas Seuerlein1
1Ulm University Hospital, Department of Internal Medicine I, Ulm, Deutschland
2Ruhr-University Bochum, St. Josef Hospital, Department of General and Visceral
Surgery, Bochum, Deutschland
3Ulm University Hospital, Department of General and Visceral Surgery, Ulm,
Deutschland
4TUM, CCC Munich-TUM and Department of Internal Medicine II, München,
Deutschland
5TUM, Department of General and Visceral Surgery, München, Deutschland
6University Medical Center Göttingen, Department of Gastroenterology,
Gastrointestinal Oncology, and Endocrinology, Göttingen, Deutschland
7University Medical Center Göttingen, Department of General and Visceral
Surgery, Göttingen, Deutschland
8University of Marburg, Department of Gastroenterology and Endocrinology,
Marburg, Deutschland
9University of Marburg, Department of General and Visceral Surgery, Marburg,
Deutschland
10Caritasklinik St. Theresia, Department of Gastroenterology, Saarbrücken,
Deutschland
11Caritasklinik St. Theresia, Department of General and Visceral Surgery,
Saarbrücken, Deutschland
12Ruhr University Bochum, Minden Department of Hematology and Oncology,
Minden, Deutschland
13Ruhr University Bochum, Department of General and Visceral Surgery Minden,
Minden, Deutschland
14Darmstadt Hospital, Department of Internal Medicine and Gastroenterology,
Darmstadt, Deutschland
15Darmstadt Hospital, Department of General and Visceral Surgery, Darmstadt,
Deutschland
16Julius Maximilians University Würzburg, Department of Internal Medicine II,
Würzburg, Deutschland
17Julius Maximilians University Würzburg, Department of General, Visceral,
Vascular and Pediatric Surgery, Würzburg, Deutschland
18Esslingen Hospital, Department of Hematology and Oncology, Esslingen am
Neckar, Deutschland
19Esslingen Hospital, Department of Surgery, Esslingen am Neckar, Deutschland
20University of Cologne, Department of Gastroenterology and Hepatology, Köln,
Deutschland
21University of Cologne, Department of Visceral Surgery, Köln, Deutschland
22University of Freiburg, Department of General and Visceral Surgery, Freiburg
im Breisgau, Deutschland
23Charite University Hospital Berlin, Department for Gastroenterology,
Rheumatology and Infectology, Berlin, Deutschland
24Ruhr University Bochum, Department of Hematology, Oncology and Palliative
Care, St. Josef-Hospital, Bochum, Deutschland
Background: Perioperative CTX in resectable PDAC is still not consid-
ered SoC and data regarding ecacy but also quality of life (QoL) are
limited. NEONAX is a randomized phase II trial in patients with rPDAC
examining perioperative (2 pre- and 4 postoperative cycles, arm A) or
adjuvant (6 cycles, arm B) of Gem/nab-P. DFS, OS and safety have already
been reported. Here we present the QoL data.
Methods: QoL was evaluated by EORTC QLQ-C30, QLQ-PAN26 and
HADS-D questionnaires: baseline, beginning of each CTX cycle, aer
neoadj. treatment in arm A as well as prior and post resection and aer 6
cycles of CTX.
Result: Global health status score (GHS-score) showed no dierence
between baseline (t1) and the timepoint aer 6 cycles of CTX (t2) in the
perioperative arm A (66.7/100 at both timepoints). Here patients expe-
rienced the lowest GHS-score pre- and postoperatively (50/100 in both
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts78
cases). Adjuvant arm B showed a deterioration in the GHS-score of 12.5
points from timepoint 1 to 2 (62.5/100 to 50.0/100). Here the lowest GHS-
score was observed within 4 weeks post-surgery (41.7/100). Physical
function score was decreased by 6.7 points (86.7/100 to 80/100) in periop-
erative arm A and by 26.7 points (86.7/100 to 60/100) in arm B between
both timepoints. Role function was reduced by 16.7 points (83.3/100 to
66.7/100) in arm A and by 33.3 points (83.3/100 to 50/100) in arm B
between both timepoints. In the remaining subscales of the used ques-
tionnaires the two arms of the trial showed comparable scores over the
whole study period.
Discussion: QoL was largely preserved in the perioperative as well as the
adjuvant arm of the NEONAX trial. GHS-score was lower pre-and postop-
eratively in arm A. e lowest GHS-score was observed postoperatively in
the adjuvant arm B. QoL was restored at the end of the treatment period in
the perioperative arm A and remained slightly reduced in arm B suggesting
that QoL is not substantially impaired by perioperative treatment in rPDAC.
Conclusion: e perioperative CTX scheme was shown to be an alterna-
tive to the standard adjuvant procedure in terms of quality of life
Disclosure Statement: e authors declare the following: Advisory Board,
Vortragshonorare: BMS
876
GSK3β;NFATc1 Subtype Specic Targeting in Pancreatic
Cancer
Aiko Bockelmann1; Umair Latif1; Kristina Reutlinger1; Sercan Mercan1;
Lukas Klein1; Karly Conrads2; Gabriela Salinas3; Marius Adler1;
Christoph Ammer-Herrmenau1; Holger Bastians4; Jovan Todorovic5;
Philipp Ströbel5; Elisabeth Heßmann1; Volker Ellenrieder1
1Department of Gastroenterology, Gastrointestinal Oncology and
Endocrinology, University Medical Center Göttingen, Göttingen, Deutschland
2Department of Medical Bioinformatics, University Medical Center Göttingen,
Göttingen, Deutschland
3Institute of Human Genetics, University Medical Center Göttingen, Göttingen,
Deutschland
4Institute of Molecular Oncology, Section for Cellular Oncology, Göttingen
Center for Molecular Biosciences (GZMB) and University Medical Center, Georg-
August University, Göttingen, Deutschland
5Institute of Pathology, University Medical Center Göttingen, Göttingen,
Deutschland
Background: Current studies demonstrate the existence of various molec-
ularly and genetically dened subtypes of pancreatic cancer, but their clin-
ical relevance and therapeutic potential are still unknown. An exception
are tumors with gBRCA1/2 mutation which are characterized by insu-
cient DNA damage repair (DDR) and are candidates for platinum-based
therapy and PARP inhibitor. e identication and characterization of
novel subtypes with addressable vulnerabilities are at the center of our
ongoing investigations.
Methods: Established models of murine and human PDAC cell lines,
patient-derived-cell lines (CDX) and -organoids (PDO) and human tissue
were used for our experiments. RNA-seq, qPCR, western-blot, ow-cy-
tometry, IHC, IF, live-cell imaging, homologous recombination (HR)
assay, BrdU and MTT studies were carried out.
Result: 16% of all human PDAC samples had high levels of GSK3β and
NFATc1 coincidently. e survival was signicantly worse in the GSK3βhigh
subgroup with sequentially high NFATc1 level. RNA-seq analyses identi-
ed GSK3β-NFATc1 regulated gene signatures involved in DDR and HR,
specically BRCA1, BRCA2, Rad51. Pharmacological or genetic inactiva-
tion of the GSK3β-NFATc1 pathway led to downregulation of DDR and
HR and HR assays showed a signicantly impaired HR. Genetic silenc-
ing of NFATc1 repressed DDR and increased basal and cisplatin-induced
DNA damage which persisted in recovery assays.
Discussion: Our studies revealed existence of a novel GSK3β;NFATc1high
subtype. Moreover, the subtype correlates with disease progression, resis-
tance, poor survival. Platin induced resistance causes increased expres-
sion and activation of the GSK3β-NFATc1 pathway, whereby NFATc1
highly regulates DDR. Finally, resistance in CDX and PDO is overcome
by targeting the GSK3β-NFATc1 pathway.
Conclusion: e GSK3β;NFATc1high subtype denes a highly aggressive
and resistant subgroup in pancreatic cancer. Moreover, targeted inacti-
vation of the GSK3β-NFATc1 pathway induces a “BRCAness phenotype,
thus resensitizing PDAC to platin-based therapy.
Disclosure Statement: e authors declare no conict of interest.
910
Pancreatic cancer – progression prior diagnosis - a phenotypic
case collection
Paul Zedler1; Martin Fasshauer2; Silke Cameron1
1Department of Gastroenterology and General Internal Medicine, Klinikum
Hann. Münden, Hann. Münden, Deutschland
2Department of Radiology, Klinikum Hann. Münden, Hann. Münden,
Deutschland
Background: At primary diagnosis, pancreatic cancer (PC) generally is
advanced with poor prognosis. Early diagnosis is the clue to better sur-
vival rates as treatment options increase.
Methods: We retrospectively evaluated whether patients with diagno-
sis of PC (06/2017-06/2023) had a pre-diagnostic CT-scan. is CT was
re- evaluated for radiologic criteria indicative of PC, i.e. focal/distal atro-
phy of the pancreatic parenchyma, focal hypoattenuation, discontinuity/
enlargement of the pancreatic duct. Further, clinical complaints and risk
criteria were assessed.
Results: Pre-diagnostic CT-imaging was available in 12/ 56 patients
(21%). e mean age at diagnosis was 74 (48-91) years. 28/56 (50%)
complained of abdominal or back pain. 10/56 (17,8%) showed newly
developed icterus. 10/56 (17,8%) had pancreatitis at primary diagnosis,
4 with icterus/acholic stools. 8/56 (14,2%) had newly developed diabetes
and 13/56 (23,2%) a known diabetes. 18/56 (32,1%) complained about
B-symptoms, of those 15/56 (26,8%) reported weight loss. 10/56 (17,8%)
had documented thrombotic events: 4 patients with deep vein thrombo-
sis, 3 with lung embolia. 6/56 (10,7%) had a prior malign tumor.
Discussion: PC is not equivalent to painless icterus. Complaints are
non-specic. A conspicuity in the CT-scan – i.e. the incidental nding of
an ‘enlarged pancreatic duct without visible obstruction’ – should lead to
an appointment at the gastroenterologist. Similarly, pancreatitis of unclear
etiology should entail timely checkup.
Conclusion: In some of the cases, an early diagnosis would certainly have
led to a dierent outcome. It remains to be hoped that in the future, a
timely exchange of radiologist, primary physician and gastroenterologist
leads to an earlier diagnosis with better therapeutic options.
Disclosure Statement: e authors declare no conict of interest.
934
Activated-pancreatic stellate cells inuence the
chemoresistance and plasticity of pancreatic adenocarcinoma
through extracellular vesicles
Xiaolin Wu1; Jiahui LI1; Fei He2; Zhefang Wang1; Hinrich Hansen1;
Margarete Odenthal1; Jiangang Zhao1; Chenghui Zhou1; Dai LI1;
Felix Popp1; Roger Wahba1; Christiane Bruns1; Yue Zhao1
1Uniklinik Köln, Köln, Deutschland
2UNIVERSITÄT BONN, Bonn, Deutschland
Background: Pancreatic ductal adenocarcinoma (PDAC) is character-
ized by a high-aggression but insensitive chemotherapy reaction. It is
becoming clear that these features of PDAC benet from a complex tumor
microenvironment (TME) with intricate crosstalk between tumor and
stromal cells. Pancreatic stellate cell (PSCs) constitutes a main element
of TME, exhibiting both quiescent and activated states. Quiescent PSCs
could transform activated PSCs (aPSC) during tumorigenesis, which then
promotes cancer chemoresistance. Extracellular vehicles (EVs) play a
bridging role in the network of cancer biology. Our study aims to explore
the eect of EVs from aPSCs on chemoresistance and tumor plasticity in
PDAC.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 79
Methods: We isolated PSCs from PDAC-adjacent normal tissues and
checked the typical markers. PSCs were activated by the tumor condition
medium. EVs were isolated from PSCs and proved the quality. Tumor che-
moresistance, metastasis, and metabolism were detected in MTT assay,
Transwell invasion and seahorse XF assay respectively. Liquid chroma-
tography-mass spectrometry veried the biological function of EVs and
PDAC cells.
Results: PSC-EVs increased the survival of PDAC cell lines in gemcit-
abine treatment, enhanced invasion and metabolic-related Warburg
eect. Furthermore, the degree of PSC activity correlated with the eect of
PSC-EVs on tumor cells. Aer comparing the PDAC mass spectrometry
data before and aer the inuence of the PSC-EVs, we explored interest-
ing markers, including epithelial-mesenchymal transition (EMT) markers
(FN1), and metabolism markers. Grem1 exhibited the highest variation
and was associated with prognosis in pancreatic cancer patients in public
databases.
Discussion: Our data suggested a signicant role of PSCs-EV on che-
moresistance and metastasis of PDAC. Grem1 was carried by EVs and
involved in this tumor-mesenchymal crosstalk, which might also be
accompanied by EMT-like and metabolic changes.
Conclusion: e eect of EVs could be boosted due to the activation of
PSCs in the TME, which may explain mutualism between the PSCs and
PDAC.
Disclosure Statement: e authors declare no conict of interest.
Genitourinary Cancer including Prostate
Cancer
37
Quality of life and patient-relevant endpoints with
darolutamide in the phase 3 ARASENS study
Karim Fizazi1; Martin Bögemann2; Mathew Smith3; Maha Hussain4;
Fred Saad5; Cora N. Sternberg6; David Crawford7; Jeanny Aragon-Ching8;
Ateesha Mohamed9; Shankar Srinivasan9; Rui LI9; Iris Kuss10;
Heikki Joensuu11; Bertrand Tombal12
1Institute Gustave Roussy Chevilly-Larue, Chevilly-Larue, Frankreich
2Universitätsklinikum Münster, Münster, Deutschland
3Massachusetts General Hospital, Boston, USA
4Robert H. Lurie Comprehensive Cancer Center of Northwestern University,
Chicago, USA
5CHUM - Centre hospitalier de l’Université de Montréal, Montréal, Kanada
6Beverly Hills Institute for Precision Medicine, Los Angeles, USA
7UC San Diego School of Medicine, San Diego, USA
8Inova Laboratories - Schar Cancer Institute, Fairfax, USA
9Bayer HealthCare Pharmaceuticals Inc, Whippany, USA
10Bayer AG, Berlin, Deutschland
11Orion, Espoo, Finnland
12Cliniques universitaires Saint-Luc (UCLouvain), Bruxelles, Belgien
Background: In ARASENS, darolutamide (DARO) + androgen-depriva-
tion therapy (ADT) + docetaxel (DOC) signicantly reduced risk of death
by 32.5% vs placebo (PBO) + ADT + DOC in patients (pts) with meta-
static hormone-sensitive prostate cancer (mHSPC). Given the potentially
long treatment duration, the impact of DARO + ADT + DOC on pt-relevant
endpoints is important to assess.
Methods: Pts were randomized 1:1 to DARO 600 mg twice daily or PBO
+ ADT + DOC. Pt-relevant endpoints were all-cause and prostate cancer
related death; time course of adverse events (AEs) of special interest; and
quality of life (QoL) based on time to worsening (TTW) of disease-related
physical symptoms.
Results: In the safety analysis set (n=1302), the DARO + ADT + DOC
arm (n=652) had fewer all-cause deaths (35.1% vs 46.8%) and prostate
cancer related deaths (26.1% vs 36.0%) vs the PBO + ADT + DOC arm
(n=650). Despite longer treatment exposure with DARO vs PBO (median
41.0 vs 16.7 months), overall AE incidence was similar in both arms.
Fatigue (DARO 33.1%, PBO 32.9%) and rash (16.6%, 13.5%) appeared
predominantly in treatment months 1–3 and decreased rapidly thereaf-
ter. Cumulative incidences of falls, fractures, and mental impairment were
low (<10%) and similar between arms. e incidence of cardiac disorders
was constant over time and similar between arms (DARO 10.9%, PBO
11.7%). Incidence of hypertension was 13.7% vs 9.2%, with similar distri-
bution over time. Most pts had high baseline QoL scores that were main-
tained over time, with comparable TTW in both arms.
Conclusions: Early treatment intensication with DARO + ADT + DOC
improved pt-relevant endpoints, with reduced all-cause and prostate can-
cer related deaths and similar incidences and time course for most AEs of
special interest vs PBO + ADT + DOC, notably with no increase in car-
diac disorders. QoL was maintained over time, and DARO had no adverse
impact on QoL, including in pts with poor prognosis.
Reused with permission from the European Society of Medical Oncology (ESMO).
Previously presented by “First author name and family name” at ESMO 2022. All
rights reserved.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
55
First-line Axitinib plus Pembrolizumab in advanced renal cell
carcinoma: retrospective real world data from a multicentre
patient cohort
Christopher Darr1; Ramona Stelmach2; Katrin Schlack3; Hendrik Dinkel3;
Pia Paenholz4; Philipp Ivanyi5; Jonas Wiegmann5; Anton Schulz6;
Mario Kramer6; Marco Schnabel7; Emily Rinderknecht7; Analena Handke8;
Thomas Hilser9; Axel Heidenreich4; Boris Hadaschik1; Stefanie Zschäbitz2;
Viktor Grünwald1,9
1Department of Urology, University Hospital Essen and German Cancer
Consortium (DKTK), Essen, Deutschland
2Department of Medical Oncology, National Center for Tumor Diseases,
Heidelberg University Hospital, Heidelberg, Deutschland
3Department of Urology, University Hospital Muenster, Münster, Deutschland
4Department of Urology, Uro-Oncology, Robot Assisted and Reconstructive
Urologic Surgery, University of Cologne Faculty of Medicine and University
Hospital Cologne, Köln, Deutschland
5Department of Hematology, Hemostasis, Oncology, and Stem Cell
Transplantation, Claudia-von Lübeck, Deutschland
7Department of Urology, University Hospital of Regensburg, Regensburg,
Deutschland
8Department of Urology, Ruhr University Bochum, Marienhospital Herne, Herne,
Deutschland
9Department of Oncology, University Hospital Essen and German Cancer
Consortium (DKTK), Essen, Deutschland
Background: Axitinib plus pembrolizumab (AXI-PEM) is a standard of
care (SOC) in advanced renal cell carcinoma (aRCC) patients (pts). We
investigated real-world eectiveness in Germany.
Methods: We retrospectively evaluated tolerability and ecacy from pts
with metastatic (m)RCC who received rst-line treatment with axitinib
5 mg orally twice daily + pembrolizumab 200 or 400 mg i.v. at 8 cancer
centers in Germany between 2019-2023. Adverse events (AEs) were
reported according to CTCAE 5.0. Objective response rate (ORR) per
RECIST 1.1. Progression Free Survival (PFS) was calculated from start of
treatment to progression or death.
Results: 163 pts were included in the analysis with a median age of
65years (range: 58-72). 68% pts were male. Clear cell RCC was the dom-
inant histology in 71% (n=116). IMDC scores were: 0 in 35 (21.5%),
≥ 1 in 121 (74.2%), missing in 7 pts (4.3%). Nephrectomy was performed
in 63.8%, prior to a/mRCC. ECOG-PS was ≥2 in 12.8%. All grade AE
occurred in 91.4% of patients, with fatigue (38.7%), diarrhea (38.7%) and
hypertension (29.4%) as most common AEs. AEs grade ≥3 occurred in
49.7% of pts. In 53.3% dose reduction or interruption of either AXI or
PEM were performed, with dose reduction of AXI in 31.2%. AXI-PEM
was permanently discontinued due to toxicities in 19% of pts. ORR was
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts80
58.3%. Complete responses were 6.7%. Primary progression was 13.5%.
Median treatment duration was 8.0 months. Median PFS was 18 months
(95-CI; 11.6-24.4). Median OS was not reached, 14.1% (n=23) deaths
occurred with a median follow-up time of 24 months. Subsequent therapy
consisted of TKI monotherapy in 57 (34.9%) pts., favouring Cabozantinib
with 80.7%.
Conclusion: Our real-world cohort supports the use of AXI-PEM as a
rst-line standard in mRCC. No new safety signals were reported, but
dose reduction was frequently utilized. Major limitation is the retrospec-
tive data capture in our study.
Disclosure Statement: e authors declare the following: Honorar und
Beratungstätigkeit: Janssen-Cilag, IPSEN, Reisekosten: Janssen-Cilag, IPSEN
74
Ecacy and Safety of Darolutamide (DARO) in Combination
with Androgen-Deprivation Therapy (ADT) and Docetaxel
(DOC) by Disease Volume and Risk in the Phase 3 ARASENS
Study
Maha Hussain1; Martin Bögemann2; Bertrand Tombal3; Fred Saad4; Karim
Fizazi5; Cora N. Sternberg6; David Crawford7; Neal Shore8;
Evgeny Kopyltsov9; Arash Rezazadeh Kalebasty10; Dingwei Ye11;
Felipe Jose Cruz12; Hiroyoshi Suzuki13; Shankar Srinivasan14;
Frank Verholen15; Iris Kuss16; Heikki Joensuu17; Mathew Smith18
1Northwestern University Feinberg School of Medicine, Chicago, USA
2Westfälische Wilhelms-Universität-Münster, Münster, Deutschland
3Cliniques universitaires Saint-Luc (UCLouvain), Bruxelles, Belgien
4CHUM - Centre hospitalier de l’Université de Montréal, Montréal, Kanada
5Gustave Roussy, Villejuif, Frankreich
6Weill Cornell Graduate School of Medical Sciences, New York, USA
7UC San Diego School of Medicine, San Diego, USA
8Carolina Urologic Research Center, Myrtle Beach, USA
9Clinical Oncological Dispensary of Omsk Region, Omsk
10University of California, Irvine, USA
11Fudan Univ. Shanghai Cancer Center, Shanghai, China, VR
12Núcleo de Pesquisa e Ensino da Rede São Camilo, São Paulo, Brasilien
13Toho University Sakura Medical Center, Chiba, Japan
14Bayer Corporation, Whippany, USA
15Bayer Consumer Care AG, Basel, Schweiz
16Bayer AG, Berlin, Deutschland
17Orion Corporation, Espoo, Finnland
18Massachusetts General Hospital, Boston, USA
Background: In ARASENS (NCT02799602), DARO + ADT + DOC
signicantly reduced the risk of death vs placebo (PBO) + ADT + DOC
in patients (pts) with metastatic hormone-sensitive prostate cancer
(mHSPC), with similar incidences of treatment-emergent adverse events
(TEAEs). DARO improved overall survival (OS) across prespecied sub-
groups, including de novo and recurrent disease. For pts with mHSPC,
outcomes based on disease volume and risk provide additional informa-
tion to clinicians.
Methods: Pts with mHSPC were randomized 1:1 to DARO 600 mg twice
daily or PBO, with ADT + DOC. High-volume disease was dened as vis-
ceral metastases and/or ≥4 bone metastases with ≥1 beyond the vertebral
column/pelvis (CHAARTED criteria). High-risk disease was dened as
≥2 risk factors: Gleason score ≥8, ≥3 bone lesions, and presence of mea-
surable visceral metastasis (LATITUDE criteria). OS for these subgroups
was assessed using an unstratied Cox regression model.
Results: Of 1305 pts assessed, 1005 (77%) had high-volume disease, 912
(70%) had high-risk disease, 300 (23%) had low-volume disease, and 393
(30%) had low-risk disease. DARO + ADT + DOC prolonged OS regard-
less of high- or low-volume disease with HRs of 0.69 and 0.68 vs PBO +
DOC + ADT, respectively. OS benet of DARO vs PBO was similar for pts
with high- or low-risk disease. DARO improved clinically relevant sec-
ondary endpoints vs PBO in high/low-volume and risk subgroups. TEAE
incidences were consistent with the overall ARASENS population across
subgroups by high/low volume and high/low risk.
Conclusions: In pts with mHSPC, the benets of early treatment intensi-
cation with DARO + ADT + DOC on OS and key pt-relevant secondary
ecacy endpoints vs PBO + ADT + DOC were similar in patients with
high- and low-volume as well as high- and low-risk mHSPC. e favor-
able safety prole of DARO was conrmed in all volume/risk populations.
DARO + ADT + DOC is one of the new standards of care for pts with
mHSPC.
© 2023 American Society of Clinical Oncology, Inc. Reused with permission.
Previously presented at the 2023 ASCO-GU Symposium. All rights reserved.
Disclosure Statement: e authors declare that there are conicts of interest.
econicts were submitted to the congress organizer KUKM GmbH and KUKM
can disclose them if needed.
83
Dosing, safety, and pharmacokinetics (PK) of combination
therapy with darolutamide (DARO), androgen-deprivation
therapy (ADT), and docetaxel (DOC) in patients with
metastatic hormone-sensitive prostate cancer (mHSPC) in the
ARASENS study
Arash Rezazadeh Kalebasty1; Peter Hammerer2; Bertrand Tombal3;
Maha Hussain4; Fred Saad5; Karim Fizazi6; Cora N. Sternberg7;
David Crawford8; Weijiang Zhang9; Bart Ploeger10; Rui LI9; Iris Kuss10;
Carsten Zieschang10; Sabine Wittemer-Rump10; Mathew Smith11
1University of California, Irvine, USA
2Städtisches Klinikum Braunschweig, Braunschweig, Deutschland
3Cliniques universitaires Saint-Luc (UCLouvain), Bruxelles, Belgien
4Northwestern University Feinberg School of Medicine, Chicago, USA
5CHUM - Centre hospitalier de l’Université de Montréal, Montréal, Kanada
6Gustave Roussy, Villejuif, Frankreich
7Weill Cornell Graduate School of Medical Sciences, New York, USA
8UC San Diego School of Medicine, San Diego, USA
9Bayer Corporation, Whippany, USA
10Bayer AG, Berlin, Deutschland
11Massachusetts General Hospital, Boston, USA
Background: In ARASENS (NCT02799602), DARO + ADT + DOC sig-
nicantly reduced risk of death vs placebo (PBO), with similar incidences
of treatment-emergent adverse events (TEAEs). We report dosing, safety
and PK of coadministration of DARO and DOC with ADT.
Methods: Patients with mHSPC were randomized 1:1 to DARO 600 mg
twice daily or PBO + ADT + DOC (75 mg/m2 q21d for 6 cycles). e eect
of DARO on DOC PK was assessed by noncompartmental analysis from
the rst 25 patients (pts) with dense PK data and by population PK for all
patients. DARO PK from ARASENS were compared with PK data from
ARAMIS (NCT02200614; without DOC) to evaluate the impact of DOC
on DARO PK.
Results: Of 1306 randomized pts, 1305 were included in the full anal-
ysis set (DARO, n=651; PBO, n=654). e median treatment duration
was longer with DARO vs PBO (41.0 vs 16.7 months) and more DARO-
treated pts (45.9% vs 19.1%) were still receiving treatment at primary
analysis cuto (Oct 25, 2021). Almost all pts completed 6 cycles of DOC
in both groups. e proportion of patients requiring DOC dose modi-
cation was similar between groups (DARO, 60.0%; PBO, 62.9%). TEAEs
led to discontinuation/reduction of DOC in 8.0%/19.9% of DARO pts and
10.3%/19.5% of PBO pts. A slight numeric increase (15% in Cmax) in
DOC exposure was observed in the DARO + DOC + ADT arm. is small
numeric increase is likely not clinically relevant given the variability in
DOC exposure (coecient of variation, 23%–54%). PK meta-analysis of
ARASENS and ARAMIS, which considered pts’ intrinsic characteristics
as covariates indicated a 10% lower AUC0-12ss of DARO in pts receiv-
ing DOC vs those not receiving DOC, which is not considered clinically
relevant.
Conclusions: DARO + DOC + ADT increased overall survival with simi-
lar incidences of TEAEs and no observed drug-drug interactions between
DARO and DOC. DARO can be eectively and safely administered with
DOC in pts with mHSPC without clinically relevant changes in PK of
DARO or DOC.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 81
© 2023 American Society of Clinical Oncology, Inc. Reused with permission.
Previously presented at the 2023 ASCO-GU Symposium. All rights reserved.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
94
Comparative real-world (RW) evidence on darolutamide
(Daro), enzalutamide (Enza), and apalutamide (Apa) for
patients (Pts) with nonmetastatic castration-resistant prostate
cancer (nmCRPC) in the United States: DEAR
Alicia Morgans1; Eva Hellmis2; Neal Shore3; Nasreen Khan4;
Niculae Constantinovici5; Javeed Khan6; Guifang Chen7; Julie Xu7;
Daniel George8
1Dana-Farber Cancer Institute, Boston, USA
2Urologicum Duisburg, Duisburg, Deutschland
3Carolina Urologic Research Center, Myrtle Beach, USA
4Bayer HealthCare, Whippany, USA
5Bayer Consumer Care AG, Basel, Schweiz
6Bayer plc, Reading, United Kingdom
7Bayer, Mississauga, Kanada
8Duke Cancer Institute, Durham, USA
Background: Novel androgen receptor inhibitors (ARIs) are recom-
mended for pts with nmCRPC. Daro has a distinct structure with low
blood-brain barrier penetration which may lead to a lower risk of cen-
tral nervous system-related adverse events (AEs) and minimal risk of
AEs commonly associated with ARIs. DEAR is the rst study compar-
ing RW utilization, outcomes, and AEs between daro and enza/apa in
nmCRPC pts.
Methods: is retrospective chart review cohort study used electronic
medical records from the PPS network of US urology practices. Eligible
pts had nmCRPC, no prior novel hormonal therapy, and initiated rst
ARI treatment (tx; index date) between 8/2019-3/2022. We describe the
% of pts who discontinued initial ARI tx (DISC), % who progressed to
metastasis (PROG), and % with AEs. A comparative analysis was done
between daro and enza/apa using Cox proportional hazards models for
time to DISC/time to PROG, adjusting for observed baseline (BL) factors.
Results: 870 pts were included (daro/enza/apa, n=362/382/126). Median
age (80/79/80 y), median BL prostate-specic antigen (PSA) doubling
time (6.8/6.4/7.4 mo), other BL characteristics, and median follow-up
were similar for daro/enza/apa. A lower % of pts had a DISC event on
daro vs enza/apa (30.4 vs 40.8/46.0) or a PROG event (17.7 vs 28.3/27.8)
during the study. Multivariate analyses adjusting for BL factors showed
that pts on daro had a lower risk of DISC and PROG over time vs enza/
apa. A lower % of pts on daro had AEs vs enza/apa (24.9 vs 29.3/30.2).
Conclusions: A lower % of pts discontinued initial ARI tx, progressed to
metastasis, or had AEs on daro vs enza/apa. When adjusting for observed
BL factors, pts on daro had considerably lower risk of DISC and PROG vs
enza/apa. is study conrms daros strong ecacy and favorable tolera-
bility prole in a RW setting. e longer tx duration seen with daro may be
associated with lower risk of progression to mCRPC vs enza/apa. © 2023
American Society of Clinical Oncology, Inc. Reused with permission.
is abstract was accepted and previously presented at the 2023 ASCO Annual
Meeting. All rights reserved.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
95
Gender-specic overall survival of patients with invasive
urothelial carcinoma and other subtypes from the largest EU
cancer registry in North Rhine-Westphalia, Germany
Niklas Schürger1; Christopher Darr1; Lennart Möller2; Hiltraud Kajüter2;
Boris Hadaschik1; Henning Reis3,4; Thomas Hilser5; Aykhan Isgandarov1;
Andreas Stang2; Viktor Grünwald1,5
1Institut für Urologie, Universitätsklinikum Essen, Essen, Deutschland
2Landeskrebsregister NRW, Bochum, Deutschland
3Institut für Pathologie, Universitätsklinikum Frankfurt, Frankfurt, Deutschland
4Institut für Pathologie, Universitätsklinikum Essen, Essen, Deutschland
5Westdeutsches Tumorzentrum, Universitätsklinikum Essen, Essen, Deutschland
Background: Invasive urothelial carcinoma (UC) occurs predominantly
in men. Dierences in stage with putative prognostic relevance are antici-
pated. We analyzed the survival of men and women in terms of histologi-
cal subtypes, localization and T-stage.
Methods: Patients diagnosed with urinary tract neoplasms (ICD-
10: C65-C68) in the NRW registry database from 2008 to 2019 were
included. Non-UC were classied as squamous cell carcinoma (SCC),
pure adenocarcinoma (ADC), pure neuroendocrine cancer (NEC),
papillary urothelial carcinoma (PUC) and unspecied variants (Other).
5-year-survival was analyzed with Kaplan-Meier method. DCO-cases are
Death-Certicate-Only.
Result: A total of 61,043 patients were studied (73% men (M) and 27%
women (W). DCO-Cases (4,620: 11.3% for M and 6.1% for W) were
excluded. Histological proportion in men was 57% UC, 29% PUC, 3%
non-UC, 11% Other and in women 60% UC, 22% PUC, 7% non-UC, 11%
Other. Distribution in T-stage M (37% T1, 26% T2, 12% T3, 5% T4, 20%
T-unknown) and W (28% T1, 29% T2, 17% T3, 6% T4, 19% T-unknown).
Overall 5-year-survival in men was 45% and in women 40%. Survival in
subtypes for men were 62% Other, 54% PUC, 38% UC, 35% ADC, 27%
SCC, 17% NEC and for women 56% Other and PUC, 33% UC, 32% ADC,
26% SCC, 22% NEC. Survival for men and women were 37% and 38% for
Upper Tract Urinary Carcinoma (C65, C66), 44% and 40% for bladder
(C67) and 50% and 36% for miscellaneous (C68). In T1 survival was 59%
for men and women. Further survival: T2 (33% M, 29% W), T3 (28% M,
30% W), T4 (14% M, 11% W) and T-unknown (52% M, 48% W).
Discussion: Previous studies have shown that women have poorer sur-
vival than men. is was explained by advanced tumors, which this study
conrmed. A higher proportion of men had T1 tumors, which were asso-
ciated with better prognosis. Our study did not reveal major gender dier-
ences according to subtypes.
Conclusion: Women with invasive UC had poorer 5-year OS than men.
However, this was not the case for non-UC subtypes, as even NEC per-
formed better in women. Localization did not aect survival in women,
whereas UTUC performed worse than bladder in men.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts82
100
Real World Evidence from a retrospective multi-center
Analysis for Ipilimumab and Nivolumab (I/N) as rst-line
treatment in patients with advanced Renal Cell Carcinoma in
dierent IMDC risk categories
Katrin Schlack1,2; Linus Materna1; Ramona Stelmach3; Stefanie Zschäbitz4;
Stephanie Neuberger5; Can Aydogdu6; Jozena Casuscelli6; Timo Egenolf7;
Matteo Silberg8; Julie Steinestel9; A. Strauß10; Florian Kirchho11; Marit
Ahrens2,12; Pia Paenholz13; Richard Cathomas14; Christopher Gossler15;
Philipp Ivanyi2,16; Marc Rehlinghaus17; Thomas Hilser18; Viktor Grünwald2,18
1Department of Urology, University Hospital Münster, Münster, Deutschland
2Interdisciplinary Working Group Kidney Tumors (IAG-N) of the German Cancer
Society, Berlin, Deutschland
3Department of Medical Oncology, National Center for Tumor Diseases,
Heidelberg University Hospital, Heidelberg, Deutschland
4Department of Medical Oncology, National Center for Tumor Diseases,
Heidelberg University Hospital, Heidelberg, Deutschland
5Department of Urology and Pediatric Urology, University Medical Center of
Johannes Gutenberg University, Mainz, Deutschland
6Department of Urology, University Hospital, Ludwig Maximilian University of
Munich, München, Deutschland
7Department of Urology and Pediatric Urology, University Hospital Würzburg,
Würzburg, Deutschland
8Department of Urology, Marienhospital Herne, Ruhr University Bochum, Herne,
Deutschland
9Department of Urology, University Hospital Augsburg, Augsburg, Deutschland
10Department of Urology, University Medicine Göttingen, Göttingen,
Deutschland
11Department of Urology, Rechts der Isar Medical Center, Technical University
München, München, Deutschland
12Department of Oncology, University Hospital Frankfurt, Frankfurt,
Deutschland
13Department of Urology, University Hospital Köln, Köln, Deutschland
14Division of Oncology/Hematology, Kantonspital Graubünden, Chur, Schweiz
15Department of Urology, Krankenhaus St. Josef, University of Regensburg,
Regensburg, Deutschland
16Department of Hematology, Hemostasis, Oncology, and Stem Cell
Transplantation, Claudia-von Schelling Comprehensive Cancer Center,
Hannover Medical School, Hannover, Deutschland
17Department of Urology, University Hospital Düsseldorf, Düsseldorf,
Deutschland
18Department of Urology, University of Duisburg-Essen and German Cancer
Consortium (DKTK)-University Hospital Essen, Essen, Deutschland
Background: I/N were approved in 2018 (CheckMate214) as rst-line
therapy for patients with advanced renal cell carcinoma (aRCC) and
IMDC intermediate or poor risk. We retrospectively evaluated ecacy
and safety in a real-world cohort.
Methods: Patients initiating I/N from 2015 to 2023 were included. We
analyzed baseline demographics, clinical characteristics, and adverse
events (AEs) descriptively. Objective response rate (ORR) was analyzed
according to local standard. Progression-free (PFS) and overall survival
(OS) were estimated using Kaplan-Meier Analyses.
Result: We included 332 patients. Median age was 63 years (IQR 54-71).
ECOG PS ≥ 2 occurred in 12.9%. IMDC risk was intermediate in 64.5%
and poor in 26.8%. 17,2% of patients did not meet the inclusion criteria
for CheckMate214 (high ECOG, comorbidities, brain metastases, auto-
immune disease, impaired renal function). Median FU was 14.5 months
(IQR 6-29). 55.1% of patients received 4 cycles of I/N. 17.8% are still on
treatment. AEs occurred in 74.4% of patients (32.2% ≥ grade 3). Toxicity
led to discontinuation of I in 25.3% and N in 13.6% of cases. Most fre-
quently observed were fatigue (22.3%), elevated liver enzymes (18.1%),
thyroiditis (16.9%), pruritus (16.9%), rash (16.6%), and diarrhea (13.9%).
Corticosteroids were used in 35.5%, high-dose (≥ 40 mg/d prednisone)
steroids accounted for 26.5% of all cases. ORR was seen in 35.8% (CR
8.7%, PR 27.1%) of patients (38.3% intermediate, 32.6% poor risk).
Median PFS was 8 months (95%CI 6.1-9.9), OS 50 months (95%CI 37.9-
62.1). Patients at intermediate risk had a PFS of 9 (95%CI 6.1-11.9) and
an OS of 50 (95%CI 37.4-62.6) months compared to poor risk patients
with 4 (95%CI 1.6-6.4) and 19 (95%CI 11.4-26.6) months, respectively.
Subsequent therapy was administered in 190 cases (57.2%), most fre-
quently given was Cabozantinib (34%).
Discussion: Patient selection was less restrictive in our clinical practice
and may explain dierences to existing data.
Conclusion: Our real-world data support the use of I/N as rst-line treat-
ment option in aRCC with safe and robust eects.
Disclosure Statement: e authors declare the following: Advisory and lectureship
fees: AAA, Amgen, Apogepha, Astellas, AstraZeneca, Bayer, BMS, Eisai, EUSA
Pharma, Fosanis, Ipsen, Janssen-Cilag, Merck, MSD, Novartis, Pzer, and Roche;
Travel expenses Amgen, AstraZeneca, Bayer, Ipsen, Sano, Janssen-Cilag, Merck,
and Pzer
116
Palliative cytoreductivenephrectomy in the era of immune
combinations
Anne Mausbach1; Konstantin Seitzer2; Christopher Darr1; Thomas Hilser3;
Linda Huberth2; Martin Bögemann2; Andres Jan Schrader2; Martin
Janssen2; Barbara Heitplatz4; Laura Maria Krabbe5; Boris Hadaschik1;
Katrin Schlack2; Viktor Grünwald6
1Department of Urology, University Hospital Essen, Essen, Deutschland
2Department of Urology and pediatric Urology, University Hospital Münster,
Münster, Deutschland
3Clinic for Internal Medicine (Tumor research), University Hospital Essen, Essen,
Deutschland
4Gerhard-Domagk-Institute of Pathology, University Hospital Münster, Münster,
Deutschland
5Department of Urology, Vivantes Humboldt Hospital Berlin, Berlin,
Deutschland
6Department of Medical Oncology, West German Cancer Center, University
Hospital Essen, Essen, Deutschland
Background: Today, target systemic therapy are standard in the 1st line
treatment of advanced/metastatic renal cell carcinoma (RCC). Although
initial nephrectomy has long been an important treatment pillar, its value
has declined recently. is study evaluated the current relevance of initial
nephrectomy in advanced stage of RCC.
Methods: We included 56 patients with advanced RCC from university
hospital Essen and Münster starting 1st line systemic therapy between
03/18 to 01/23, of which 56% had a clear cell type. We assigned patients
into two cohorts, either cytoreductive surgery followed by systemic
therapy (cohort 1; 30 patients) or vice versa (cohort 2; 26 patients). ey
received either combinations of TKI and IO (77%) or anti-VEGF-TKI
monotherapy (23%). We investigated progression-free survival (PFS;
measured with Kaplan-Meier-method from start of systemic therapy
or nephrectomy to progression or death) and objective response rate
(ORR) according to RECIST1.1. Result: e age of the patients ranged
from 43 to 80 years with a median of 63 years, 64% had intermediate
and 36% had poor IMDC-risks. Median follow-up-time was 48 months.
Median PFS of 7 vs. 20 months showed a longer progression-free time in
cohort 2 (95% CI 5,7-16; p 0.02). e 36-months PFS was 6.7% (cohort
1) and 19.2% (cohort 2), respectively. In cohort 1, there were 32.7% with
progressive disease (PD), in cohort 2, 3.6%. ORR is 33% (cohort 1) vs.
84% (cohort 2). In cohort 1, 26.7% had to discontinue therapy due to
toxicity, in cohort 2, 16%.
Discussion: e sequence of systemic therapy followed by nephrectomy
was associated with a signicant PFS advantage. Nephrectomy followed
by systemic therapy was associated with a higher primary progression and
discontinuation rate. Major limitation is the retrospective nature of our
analysis and the clinical selection process, which may introduce bias to
our analysis.
Conclusion: e sequence of therapy followed by nephrectomy in
advanced RCC was associated with noticeably better outcomes than the
reverse sequence. Our observation warrants prospective studies.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 83
181
Split-dose cisplatin (C) + gemcitabine (G) use and associated
clinical outcomes in the rst-line (1L) treatment (tx) of locally
advanced or metastatic urothelial cancer (la/mUC): results of a
retrospective observational study in Germany (CONVINCE)
Katrin Schlack1; Thomas W. Kubin2; Markus Ruhnke3; Clemens Schulte4;
Stefan Machtens5; Anna Eisen6; Ulrike Osowski7; Silke Günther8;
Mairead Kearney8; Rainer Lipp6; Stephan Schmitz9
1Department of Urology, University Hospital Muenster, Muenster, Deutschland
2Department für Hematology, Oncology and Palliative Care, Clinics
Südostbayern AG, Clinic Traunstein, Traunstein, Deutschland
3Clinic for Hematology, Oncology and Palliative Medicine, Helios Clinic Aue,
Aue, Deutschland
4Practice for Hematology and Oncology, Dortmund, Deutschland
5Department of Urology, GFO Hospitals Rhein-Berg, Marien-Hospital, Bergisch-
Gladbach, Deutschland
6GermanOncology GmbH, Hamburg, Deutschland
7Merck Healthcare Germany GmbH, an aliate of Merck KGaA, Weiterstadt,
Deutschland
8Merck Healthcare KGaA, Darmstadt, Deutschland
9Medical Care Center for Oncology and Hematology, Cologne, Deutschland
Background: Platinum-based chemotherapy (PBC) followed by ave-
lumab 1L maintenance in patients (pts) without progressive disease is the
standard 1L tx for la/mUC. In pts ineligible for standard-dose C (1 day
per cycle), carboplatin (Cb) or split-dose C (35 mg/m2 on days 1 + 8) are
alternative options. e eectiveness of these regimens vs standard-dose
C has not been extensively examined. In this real-world (rw) study, we
compared clinical outcomes in pts with la/mUC who received 1L split-
dose C + G (CG-S) vs standard-dose C + G (CG) or Cb + G (CbG).
Methods: CONVINCE (initiated in Dec 2021) enrolled 188 pts who
received 1L tx in 2019-2020 in 27 oncology or urology institutions in
Germany. Objective response rate (ORR), rw progression-free survival
(rwPFS) and overall survival (rwOS) were compared between CG-S vs CG
and CG-S vs CbG groups. rwOS and rwPFS were estimated by Kaplan-
Meier analysis.
Results: 124/188 (66.0%) enrolled pts received 1L PBC + G: 27 (21.8%)
received CG-S, 75 (60.5%) CG, and 22 (17.7%) CbG. Median age was
66, 69, and 73 years, respectively. Most pts were male (CG-S, 70.4%, CG,
73.3%, CbG, 77.2%) and had an ECOG PS of 0/1 at diagnosis (CG-S,
59%/37%, CG, 55%/40%, CbG, 46%/50%). Median follow-up was 16.5
months. Median no. of cycles was 5, 4, and 6, respectively. In 116/124
evaluable pts, ORR with CG-S, CG, and CbG was 64.0%, 49.3%, and
59.1%, respectively (p=0.84 for CG-S vs CG; p=0.65 for CG-S vs CbG).
In the overall population (n=124), median rwPFS was 10.5, 10.5, and 9.1
months, respectively (p=0.35 for CG-S vs CG; p=0.24 for CG-S vs CbG).
Median rwOS was 14.4, 18.8, and 16.7 months, respectively (p=0.06 for
CG-S vs CG; p=0.14 for CG-S vs CbG).
Discussion: Despite its small sample size, this rw study provides valuable
insights into the use of 1L CG-S in routine clinical practice in Germany.
Conclusions: CG-S showed broadly comparable outcomes vs CG or CbG.
is analysis suggests that CG-S can be a viable alternative for pts with la/
mUC unsuitable for CG, without compromising tx eectiveness.
Previously presented at ESMO 2023, “FPN: 2388P”, “Katrin Schlack et al.” -
Reused with permission.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
265
Treatment duration and long-term safety and tolerability of
darolutamide in nonmetastatic castration-resistant prostate
cancer (nmCRPC): ARAMIS Rollover Study
Neal Shore1; Martin Bögemann2; Murilo Luz3; Albertas Ulys4;
Shankar Srinivasan5; Etah Kurland5; Karim Fizazi6
1Carolina Urologic Research Center, Myrtle Beach, USA
2Westfälische Wilhelms-Universität-Münster, Münster, Deutschland
3Erasto Gaertner Hospital, Curitiba, Brasilien
4Universität Vilnius, Vilnius, Lithuania
5Bayer HealthCare, Whippany, USA
6Gustave Roussy, Villejuif, Frankreich
Introduction: We report the long-term safety and tolerability of darolut-
amide (DARO) in the ARAMIS Rollover Study (ROS; NCT04464226).
Methods: In ARAMIS, 954 patients (pts) received double-blind (DB)
DARO 600 mg orally twice daily, of whom 591 pts continued on open-
label (OL) DARO following the primary analysis. On completion of
ARAMIS, 294 pts with no evidence of metastases and benetting clini-
cally from DARO entered the ROS. DARO treatment duration and safety
are described for the 954 pts over the DB, DB+OL, and DB+OL+ROS
periods.
Results: At data cut-o of Jan 31, 2022, median (range) duration of
DARO treatment was DB 1.5 years (0.0–4.0), DB+OL 2.1 years (0.0–4.9),
and DB+OL+ROS 2.8 years (0.0–6.8). Of the 954 randomized pts, 32.3%
received DARO treatment for ≥2–<4 years, 17.3% for ≥4–<5 years, and
12.8% for ≥5 years. As expected, cumulative incidences of treatment-emer-
gent adverse events (TEAEs) increased slightly with longer observation
time. For the DB, DB+OL, and DB+OL+ROS periods, respectively, TEAE
incidences were: any grade 85.7%, 89.8%, 91.5%; grade 3/4 26.3%, 31.8%,
35.5%; serious 26.1%, 32.1%, 38.5%; and leading to treatment discontin-
uation 8.9%, 10.5%, 12.9%. Increases in incidences of TEAEs commonly
associated with androgen receptor inhibition across the DB, DB+OL, and
DB+OL+ROS periods were mostly minimal. During the rst 24 months
of DARO treatment, incidences of most of these TEAEs were low and
≤2% dierent vs placebo, except for fatigue. Onset of these TEAEs by
time intervals across all study phases (DB, DB+OL, DB+OL+ROS) will
be presented.
Conclusions: Approximately 30% of pts with nmCRPC remained on
DARO for ≥4 years, suggesting long-term clinical benet. Most adverse
events occurred in the rst 2 years of treatment, with small increments
over time. e favorable safety prole of DARO was maintained with
long-term exposure. No new safety concerns were observed in the ROS.
© 2023 American Urological Association. Reused with permission. Previously pre-
sented at the 2023 AUA Annual Meeting. All rights reserved.
Disclosure Statement: e authors declare that there are conicts of interest.
econicts were submitted to the congress organizer KUKM GmbH and KUKM
can disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts84
276
Factors associated with not receiving systemic anticancer
treatment (tx) in patients (pts) with metastatic urothelial
carcinoma (mUC): results of a retrospective observational
study in Germany
Günter Niegisch1; Mairead Kearney2; Julia Krieger3; Ulrike Osowski4;
Carina Weinhold4; Barthold Deiters5; Ulf Maywald6; Silke Günther2;
Thomas Wilke7; Marc-Oliver Grimm8
1University Hospital and Medical Faculty of the Heinrich-Heine University,
Düsseldorf, Deutschland
2Merck Healthcare KGaA, Darmstadt, Deutschland
3Cytel, Berlin, Deutschland
4Merck Healthcare Germany GmbH, an aliate of Merck KGaA, Weiterstadt,
Deutschland
5GWQ ServicePlus AG, Düsseldorf, Deutschland
6Drug Department, AOK PLUS, Dresden, Deutschland
7IPAM eV, Wismar, Deutschland
8Universitätsklinikum Jena, Jena, Deutschland
Background: Real-world studies show that many pts with mUC do not
receive systemic tx. With the expanding therapeutic landscape for mUC,
identifying factors associated with undertreatment to mitigate outcome
disparities is essential.
Methods: is study identied adults with an incident mUC diagnosis
(dx; ICD-10 codes C65-68 + C77-79) in 2015-19 using 2 German statu-
tory health insurance (SHI) claims databases (2013-20, ≈8 mil. insured).
Baseline (BL) characteristics within 24 mo before dx were analyzed. Aer
dx, pts were followed for ≥12 mo or until death. Overall survival (OS) was
estimated by Kaplan-Meier analysis. Variables associated with receiving
systemic tx were identied using multivariable logistic regression.
Results: Overall, 3,226 pts (mean age, 73.8 y; male, 70.8%; mean Charlson
Comorbidity Index [CCI] score, 6.3) were identied. Mean follow-up was
13.8 mo. 1,892 pts (58.6%) did not receive systemic tx within 12 mo of
mUC dx. Median OS aer dx was notably shorter in untreated vs treated
pts: 3.0 vs 13.7 mo in SHI 1 and 3.6 vs 13.8 mo in SHI 2, respectively.
Untreated pts were signicantly older vs treated pts (≥80 y: 48.2% vs
13.5%); had considerably more comorbidities (mean CCI: 6.8 vs 5.5); and
had a higher care level (37.5% vs 11.0%). Factors associated with a higher
likelihood (odds ratio [95% CI]) of not receiving tx included older age
(at index, continuous; 0.93 [0.92-0.94]; p<0.001), no prior UC-related
surgery/tx (24-mo BL; 1.65 [1.37-2.00]; p<0.001), earlier dx in the study
period (reference, 2015; 1.11 [1.05-1.17]; p<0.001), CCI (24-mo BL, con-
tinuous; 0.97 [0.93-1.00]; p=0.011), and outpatient diagnosis setting (1.28
[1.05-1.54]; p=0.013).
Discussion: Low tx rate and shorter OS in untreated vs treated pts are
consistent with prior studies.
Conclusion: Identied factors associated with undertreatment, such as
older age and more comorbidities, need to be addressed by oering better
tolerated mUC tx and educating pts on the benets of systemic tx.
Previously presented at ESMO 2023, “FPN: 2386P”, “Günter Niegisch etal.” -
Reused with permission.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
298
Discontinuation of Active Surveillance in younger patients
with prostate carcinoma
Kevin Claaßen1; Christina Justenhoven2; Volker Arndt3; Silke Hermann3;
Susanne Bergbold3; Jale Lakes4; Dominique Werner1; Hiltraud Kajüter1;
Catherine Real1; Andreas Stang1; Peter Albers4
1Landeskrebsregister NRW, Bochum, Deutschland
2IDG Institut für digitale Gesundheitsdaten RLP, Mainz, Deutschland
3Epidemiologisches Krebsregister Baden-Württemberg, Heidelberg,
Deutschland
4Universitätsklinikum Düsseldorf, Klinik für Urologie, Düsseldorf, Deutschland
Background: Localized prostate carcinoma shows a very low 10-year
cancer-specic mortality of less than three percent. e strategy of Active
Surveillance can delay or avoid side eects of radical curative inter-
ventions. (1) However, the evidence concerning Active Surveillance in
younger patients below 60 years is scarce.
Methods: Based on data from the state-wide cancer registries of North Rhine-
Westphalia, Baden-Württemberg and Rhineland-Palatinate, the courses
of n = 700 patients < 60 years diagnosed with localized prostate carcinoma
between 2016 and 2021 and initially under Active Surveillance are described.
Relevant endpoints are the 2-year discontinuation rate, median time on
Active Surveillance and the presence of histological progression based on
Gleason score. Active contacting of health care providers is currently ongoing
within the framework of the research project “Prostatakarzinom des jungen
Mannes” (ProjuMa) in order to increase the completeness of the data.
Result: Relatively high discontinuation rates with low median duration
are expected, which would be not only due to histological progression of
the disease, but also due to limited adherence to the treatment strategy.
Final analyses will be available in the fourth quarter of 2023.
Discussion: Beyond the clinical rationale, both the psychological burden
of the patient as well as caution and incentive structure of the treating
physician may lead to discontinuation of Active Surveillance.
Conclusion: is study will provide a rst quantication of the rate of dis-
continuations of Active Surveillance and its association with histological
progression in young patients with localized prostate cancer in Germany.
Indication of source:
1 Hamdy et al. (2016): 10-Year Outcomes aer Monitoring, Surgery, or
Radiotherapy for Localized Prostate Cancer. In: N Engl J Med.
Disclosure Statement: e authors declare no conict of interest.
455
Characteristics and outcomes of patients (pts) with Metastatic
Castration-Resistant Prostate Cancer (mCRPC) treated with
Lutetium-177–PSMA-617 (PSMA-RLT) in a Real-World Setting
David Kersting1; Moon-Sung Kim2; Lukas Püllen3; Katharina Seidl-
Rathkopf4; Nicole Schinwald4; Philani Mpofu5; Ivy Altomare5;
Arun Sujenthiran6; Trevor Royce5; Christoph Buhl4; Viktor Grünwald3;
Ken Herrmann1; Jens Kleesiek2; Boris Hadaschik3
1Department of Nuclear Medicine, University of Duisburg-Essen and German
cancer consortium (DKTK), partner site University Hospital Essen, Essen,
Deutschland
2Institute for AI in Medicine (IKIM), University of Duisburg-Essen and German
cancer consortium (DKTK), partner site University Hospital Essen, Essen,
Deutschland
3Department of Urology, University of Duisburg-Essen and German cancer
consortium (DKTK), partner site University Hospital Essen, Essen, Deutschland
4Flatiron Health GmbH, Köln, Deutschland
5Flatiron Health Inc., New York, USA
6Flatiron Health UK Ltd, London, United Kingdom
Background: is retrospective cohort study describes characteristics
and real-world (rw) overall survival (OS) of pts with mCRPC treated with
PSMA-RLT at Essen University Hospital (UKE). We contextualize these
ndings with results from a US-based mCRPC cohort that did not receive
PSMA-RLT.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 85
Methods: e UKE cohort included mCRPC pts treated with ≥ 1 cycle
of PSMA-RLT from 11/2017 to 10/2022. Data comprised structured and
unstructured data from UKE’s electronic health record (EHR). e US
cohort was selected from the nationwide EHR-derived Flatiron Health
database. It included pts with mCRPC diagnosis (dx) from 01/2014 to
09/2021 who received tx (=index tx) following ≥ 1 taxane and ≥ 1 andro-
gen receptor pathway inhibitor (ARPI).
Result: In the UKE cohort (N = 219, median (med) age: 73, interquartile
range (IQR): 67, 78) med time from initial dx and mCRPC dx to the initi-
ation of PSMA-RLT was 69 mos (IQR: 42, 128) and 23 mos (IQR: 13, 40),
respectively. Pts were heavily pre-treated (≥ 2 taxanes: 27.8%; ≥ 2 ARPIs:
58.9%). Disease burden at tx start was extensive, as indicated by sites of
metastases (bone: 95%, lymph nodes: 82.6%). Med OS from the start of
PSMA-RLT was 9.8 mos (95% CI: 8.6, 11.3). In the US cohort (N = 857,
med age = 71, IQR: 65, 78) 11.1% of pts received prior tx with ≥2 taxanes
and 35% with ≥ 2 ARPIs. Disease burden at index tx was as follows: bone:
91.5%, lymph nodes: 51.5%. Med time from initial dx and mCRPC dx to
index tx was 49 mos (IQR: 27, 99) and 16 mos (IQR: 10, 25), respectively.
Med OS for US patients was 8.5 mos (95% CI:7.6, 9.1).
Discussion: e study design did not allow for a direct comparison
between the two cohorts. Qualitatively, UKE patients were heavily
pre-treated with extensive disease burden at the start of PSMA-RLT.
Nevertheless, the study demonstrated promising rw outcomes for patients
with mCRPC under PSMA-RLT.
Conclusion: is study provided the unique opportunity to describe rw
outcomes for late stage mCRPC patients treated with PSMA-RLT. Future
work, including the direct comparison of PSMA-RLT versus other tx in a
similar setting, will help understand the benet of this novel tx.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
499
e-Konsil - Teleconsultations for urological tumors
Marianne Leitsmann1; Boris Pöhlmann2; Björn Broge2; Mark Schrader3;
Chris Protzel4; Maurice-Stephan Michel5; Susanne Krege6; Michael Siebels7
1Klinik für Urologie, Medizinische Universität, Graz, Österreich
2aQua-Institut GmbH, Göttingen, Deutschland
3Klinik für Urologie, Helios Klinik, Berlin-Buch, Deutschland
4Klinik für Urologie, Helios Klinik, Schwerin, Deutschland
5Universitätsklinik für Urologie und Urochirurgie, Universität Heidelberg-
Mannheim, Mannheim, Deutschland
6Klinik für Urologie, Evang. Kliniken Essen-Mitte, Essen, Deutschland
7Urologie Pasing, München, Deutschland
Purpose: Patients have the right to the best possible treatment. Especially
in complex oncological cases, seeking a second opinion can be benecial.
Methods: e platform ‘e-Konsil’ (https://www.ekonsil.org/) facilitates
teleconsultations for patients with testicular tumors, penile carcinoma,
or metastatic renal cell carcinoma, oering the opportunity for nation-
wide expert opinions. e treating physician completes medical data and
planned therapy in an input matrix with patient consent. ese are then
forwarded to a specialist for assessment, who provides recommendations.
e follow-up documentation captures the therapy actually performed, as
well as entity-specic outcomes up to 6 years.
Results: Since 2017, a total of 3876 expert opinions have been requested
by 906 participants. ese have been reviewed by 47 experts. is corre-
sponds to approximately 15% of all urologists in Germany. e alignment
of therapy plans resulted f.e. in a modication of treatment decisions in
about 30% of testicular tumor cases. Similar was also observed for the
other two entities.
Discussion: e Teleconsultation Agreement according to § 291g SGB V
will allow billing through the EBM in the future and entry into standard
care provision. erefore, teleconsultations will become an integral part
of medical care in the future. In addition to the further development of
the process (integration with the Telematik infrastructure, DICOM image
transmission, second opinion procedures, automated billing), the plat-
form e-Konsil aims to transfer the model to other oncological specialties.
Conclusions: Telemedical consultations enhance the quality of patient
care, facilitate local treatment by the familiar healthcare provider, and are
accessible on a regional as well as cross-sectoral basis.
Disclosure Statement: e authors declare no conict of interest.
745
Interim analysis (IA) from RENALISTIC: a retrospective chart
review of rst-line (1L) therapy in patients with advanced
renal cell cancer (aRCC) in Germany
Christian Doehn1; Peter Brecht2; Rosemary E. Teresi3; Gina Rüter4;
Ulrike Osowski5; Mairead Kearney5; Allison Thompson3; Rainer Lipp2
1Urologikum Lübeck, Lübeck, Deutschland
2GermanOncology GmbH, Hamburg, Deutschland
3Pzer Inc, New York, USA
4Pzer Pharma GmbH, Berlin, Deutschland
5Merck KGaA, Darmstadt, Deutschland
Background: e treatment of aRCC has signicantly changed in recent
years. Prior to the approval of combination therapies, tyrosine kinase
inhibitor (TKI) monotherapy was considered the standard 1L therapy
of aRCC. Immune checkpoint inhibitor (ICI) + TKI/ICI combinations
were approved in the EU in 2019 and 2020, respectively. RENALISTIC
launched in Oct 2022 to gather real-world data on the uptake/outcomes
of new therapies in Germany. We report results of an IA including the rst
50 patients.
Methods: RENALISTIC is an anonymized retrospective chart review of
patients who started 1L for aRCC in oncological and urological insti-
tutions from 2020-2021. An IA assessing value of documentation and
derived information was planned. Descriptive analyses were conducted
and the Kaplan-Meier method was used to assess time-to-event outcomes.
Results: Data from 50 patients from 10 institutions (urology/oncology,
12%/88%; practice/hospital, 92%/8%) were evaluable through April 15,
2023. erapies received were reported as ICI+TKI: 42%, ICI+ICI: 20%,
TKI alone: 30%, ICI alone: 8%. e median progression-free survival
(PFS) (months) diered by treatment; ICI+TKI: 9.1, ICI+ICI: 2.7, TKI
alone: 3.2, ICI alone: 1.6. Median follow-up was 13.8 months. At time
of analysis, 76% (n=38) had discontinued 1L due to progressive disease
(n=13), physician/patient wish (n=8), death (n=7), performance status
deterioration (n=4), toxicity (n=3), and unknown (n=3).
Discussion: e use of combination therapy for the treatment of aRCC
has been observed following regulatory approvals; this is reected in the
highest proportion of patients in this IA receiving ICI+TKI in 1L. For
ICI+TKI, median PFS was 9.1 months, which is consistent with clinical
trials and similar studies.
Conclusion: Limitations of this IA include the small number of patients
and missingness of data; however, the value of documentation was con-
rmed, and RENALISTIC will continue. Additional patients and fol-
low-up will provide information on toxicity management and treatment
approaches of medical disciplines/institutions.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts86
750
Toxicity and Ecacy after Fiducial-based Stereotactic Body
Radiotherapy in Prostate Cancer witht a Linear Accelerator
(LINAC)
Simon KB Spohn1,2,3; Marco Serpa2,4; Rolf Wiehle2,4; Paolina Toncheva1,2;
Carlotta Rizzo4; Sophie Küchler2,4; Thomas Rothe2,4; Simon Kirste1,2,2;
Constantinos Zamboglou1,2,5; Dimos Baltas2,4; Anca-L. Grosu1,2
1Department of Radiation Oncology - University Medical Center Freiburg,
Freiburg, Deutschland
2German Cancer Consortium (DKTK) Partner Site Freiburg -German Cancer
Research Center (DKFZ), Heidelberg, Deutschland
3Berta-Ottenstein-Programm, Faculty of Medicine, University of Freiburg,
Freiburg, Deutschland
4Department of Radiation Oncology, Division of Medical Physics, University
Medical Center Freiburg, Freiburg, Deutschland
5German Oncology Center, European University of Cyprus, Limassol, Zypern
Background: Localised prostate cancer (PCa) can be treated with ste-
reotactic body radiotherapy (SBRT) in a few sessions and ablative doses.
Intrafractional movement of the prostate poses a challenge to safe treat-
ment delivery. Here we present the toxicity and ecacy at a median fol-
low-up (FU) of 18 months aer ducial-based image-guided radiotherapy
(IGRT) at the conventional linear accelerator (LINAC).
Methods: 8 patients who received SBRT between February 2021 and
August 2022 were included in this analysis. SBRT was delivered aer
implantation of 3 ducials in 5 fractions with prescribed doses between
36.25 and 40 Gy using volumetric intensity modulated arc therapy
(VMAT). An IGRT workow with combined stereoscopic imaging and
cone beam computer tomography was used. Imaging was performed at
predened times during treatment. Table corrections were applied in 6
DOF if a threshold of >1° rotation or >1 mm translation was exceeded. FU
was performed every 3-6 months. Gastrointestinal (GI) and genitourinary
(GU) toxicity was assessed by CTCAEv5.
Result: Median PSA before RT was 8.7 ng/ml (6.1 - 15ng/ml). Median
FU was 18 months (12-30 months). Figure 1 shows GU and GI toxicities
at end of treatment, 3 months, 12 months and at last FU. ere were no ≥
grade III toxicities. At last FU, no ≥ grade II toxicities were observed and
mean PSA was 0.95 ng/ml (0.2-2.6ng/ml).
Discussion: SBRT delivered with the ducial-based workow shows very
low toxicity rates aer a median FU of 18 months. Only one grade II tox-
icity was observed at the last FU. e large PSA reduction to a median of
<1ng/ml suggests a successful ablative treatment.
Conclusion: SBRT can be safely delivered with correction of intrafrac-
tional motion with a LINAC. SBRT with focal dose escalation based on
functional imaging is currently being investigated in the HypoFocal
SBRT trial.
Disclosure Statement: e authors declare no conict of interest.
816
Achieving an undetectable PSA <0.1ng/ml following
SRT predicts the outcome of patients receiving SRT for
biochemical recurrence following RP
Sophia Scharl1,2; Luca Gartner2; Dirk Böhmer3; Alessandra Siegmann3;
Daniel Zips4; Reinhard Thamm1; Manuel Krafcsik2; Benjamin Mayer5;
Thomas Wiegel2
1Universitätsklinikum Ulm, Ulm, Deutschland
2Universitätsklinikum Ulm, Ulm, Deutschland
3Charité Campus Mitte, Berlin, Deutschland
4Charité Campus Mitte, Berlin, Deutschland
5Universität Ulm, Ulm, Deutschland
Background: Achieving an undetectable PSA <0.1ng/ml following SRT
has been demonstrated to predict the outcome of patients by previous
publications. e aim of this retrospective study was to evaluate whether
this eect persists in an updated larger cohort with longer follow-up time.
Methods: 678 prostate cancer patients of two university centers treated
with SRT to the prostatic fossa for BR aer RP were included. Exclusion
criteria were lymph node or distant metastases before SRT, pre-SRT
PSA>3ng/ml and ADT between RP and SRT. Log-rank test and Cox
regression analysis were used to evaluate the impact of disease and treat-
ment related parameters on BPFS, MFS and OS.
Result: Median follow-up time aer SRT was 5.6 years. 5- year BPFS was
77.8% in patients with a PSA nadir <0.1 ng/ml and 16.3% in the remaining
cohort (p<0.001). 5- year MFS was 95.3% in patients with undetectable
PSA versus 84.0% in those with detectable PSA following SRT (p<0.001).
5- year OS was 97.5% in patients with a PSA nadir <0.1 ng/ml and 92.7%
in the remaining cohort (p=0.04). In multivariate analysis, PSA nadir <0.1
ng/ml remained a statistically signicant predictor for BPFS (p <0.001,
HR: 8.202, 95%-CI: 5.357-12.557) and MFS (p<0.001, HR: 3.813, 95%-CI:
1.986-7.322), but not for.
Discussion: The prognostic value of PSA nadir <0.1 ng/ml on OS was
only present in univariate analysis. The reason for PSA nadir losing
its predictive power in multivariate analysis might be the high age
average of patients with prostate cancer and the option of ADT as sal-
vage treatment. Patients that achieved an undetectable PSA following
SRT had an excellent outcome, whereas the remaining patients had a
terrible outcome. Considering these results, it seems plausible to take
PSAresponse to SRT into account when thinking about adding ADT
to SRT.
Conclusion: PSA <0.1 ng/ml following SRT without ADT is a signi-
cant predictor of BPFS and MFS. We assume that it might be feasible to
withhold ADT in selected patients that if they achieve an undetectable
PSA aer SRT. Further prospective studies are warranted to conrm these
results.
Disclosure Statement: e authors declare no conict of interest.
848
Incidence and survival of patients with prostate cancer in a
population-based dataset
Madeleine Karpinski1; Kevin Claaßen1; Lennart Möller1; Johannes Hüsing1;
Wolfgang Fendler2; Hiltraud Kajüter1; Andreas Stang1,3
1Landeskrebsregister NRW gGmbH, Bochum, Deutschland
2Department of Nuclear Medicine, University Hospital Essen, Essen,
Deutschland
3Institute of Medical Informatics, Biometry and Epidemiology, University
Hospital Essen, Essen, Deutschland
Background: is analysis gives an update on the incidence of pros-
tate cancer and its survival. We especially studied the incidence in rela-
tion to changing recommendations on Prostate-Specic-Antigen (PSA)
screening.
Methods: Age-standardized incidence rates and 5-year relative survival
(RS) (period approach) were calculated using data from the cancer reg-
istry of the administrative district Münster and North Rhine-Westphalia
respectively for the years 1992-2019. Analyses were stratied according to
the TNM classication.
Result: Until 2008 overall prostate cancer incidence increased, fol-
lowed by a decrease up to 2017 and another increase. The same time
trend was observed only in non-metastatic tumors but not in met-
astatic tumors. Incidence of tumors with lymph node metastases
increased before and decreased after 2017. Overall 5-year RS showed
an increase of +12% up to period 2006-2007, after that it remains
constant. The median survival with non-metastatic prostate cancer
(96.02%) or with lymph node metastases (92.04%) was higher com-
pared to distant metastases (49.9%).
Discussion: Incidence rates reect changes of recommendation in PSA
screening guidelines from the United States. e increase in non-meta-
static tumors in particular aer 2017 may reect increased PSA screening.
An increase in RS can be an expression of lead time bias.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 87
Conclusion: Higher survival rates in local tumors and tumors with lymph
node metastases show, that the challenge is to detect distant metastases
early. Incidence rates demonstrate that disease progression cannot be
mastered by PSA screening alone, but possibly by additionally applied
diagnostic methods in the future.
Disclosure Statement: e authors declare no conict of interest.
868
Symptomatic vs. non-symptomatic urothelial carcinoma:
5-years results from the VERSUS study
Christian Doehn1; Frank König2; Jörg Klier3; Robert Schönfelder4;
Manfred Johannsen5; Jörg Schröder2; Elke Hempel6;
Rolf Harald Eichenauer7
1Urologikum Lübeck, Lübeck, Deutschland
2ATURO, Berlin, Deutschland
3UPK, Köln, Deutschland
4Urologie Schönfelder & Strasser, Hamburg, Deutschland
5Urologie Johannsen & Laux, Berlin, Deutschland
6SMGF, Berlin, Deutschland
7Urologikum Hamburg, Hamburg, Deutschland
Background: Since May 2018, members of d-uo have been document-
ing urologic tumor cases as part of the prospective VERSUS study. We
asked ourselves whether there are dierences between symptomatic and
non-symptomatic patients with urothelial carcinoma regarding age and
tumor stage at initial diagnosis.
Methods: By April 2023, 16,916 patients with an initial diagnosis of urologic
tumor disease were documented. Urothelial carcinoma was present in 4,205
patients (24.9%). ere were 3,250 men (77.3%) and 955 women (22.7%).
Result: Urothelial carcinoma was diagnosed due to symptoms in 2,313
patients (55%) and by another route in 1,892 patients (45%). e median
patient age, with no relevant gender dierence, was 71.5 years in patients
with symptoms and 71.3 years in patients without symptoms. e dis-
tribution of UICC stages were (symptomatic patients/non-symptom-
atic patients): UICC 0: 47.3%/55.3%; UICC I: 28.4%/25.5%; UICC II:
16.5%/11.7%; UICC III: 2.4%/2.3%; UICC IV: 5.4%/3.8%.
Discussion: We herein present current real world data from Germany
demonstrating that patients with urothelial carcinoma and symptoms do
not dier in age from patients with any other cause of diagnosis. However,
patients with symptoms show less favorable tumor stages.
Conclusion: Our nding may have impact on early diagnosis as well as
staging and therapy of patients with urothelial carcinoma.
Disclosure Statement: e authors declare no conict of interest.
890
PSMA-PET and mpMRI-based focal dose escalation in
denitive radiotherapy of prostate cancer: 2-year results of
the HypoFocal phase II study
Simon KB Spohn1,2,3; Mark Gainey4; Marius Kamps5; Cordula Annette Jilg5;
August Sigle5; Christian Gratzke5; Michael MIX6; Martin Freitag6;
Sophia Louisa Bürkle1; Tanja Sprave1,2; Simon Kirste1,2; Hannes Engel7;
Sebastian Zschaeck8,9; Pirus Ghadjar8; Dimos Baltas2,4;
Constantinos Zamboglou1,2,10; Anca-L. Grosu1,2
1Department of Radiation Oncology, University Medical Center Freiburg, Faculty
of Medicine, University of Freiburg, Freiburg, Deutschland
2German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer
Research Center (DKFZ), Heidelberg, Deutschland
3Berta-Ottenstein-Programm, Faculty of Medicine, University of Freiburg,
Freiburg, Deutschland
4Department of Radiation Oncology, Division of Medical Physics, University
Medical Center Freiburg, Faculty of Medicine, Freiburg, Deutschland
5Department of Urology, University Medical Center Freiburg, Faculty of
Medicine, University of Freiburg, Freiburg, Deutschland
6Department of Nuclear Medicine, University Medical Center Freiburg, Faculty
of Medicine, University of Freiburg, Freiburg, Deutschland
7Department of Radiology, University Medical Center Freiburg, Faculty of
Medicine, University of Freiburg, Freiburg, Deutschland
8Department of Radiation Oncology, Charité—Universitätsmedizin Berlin,
Corporate Member of Freie Universität Berlin and Humboldt-Universität zu
Berlin, Berlin, Deutschland
9German Cancer Consortium, Partner Site Berlin, Heidelberg, Deutschland
10German Oncology Center, European University of Cyprus, Limassol, Zypern
Background: e prospective, 2-armed, non-randomised phase II
HypoFocal trial investigates the safety and feasibility of PSMA-PET
and mpMRI-based focal dose-escalated moderately hypofractionated
radiotherapy (MHRT) and high-dose-rate brachytherapy (HDR-BT) in
patients with prostate cancer (PCa). Here we present the two-year toxicity
(tox) and quality of life (QoL) results.
Methods: Patients with NCCN intermediate/high risk PCa (cN0 cM0)
received MHRT of 60 Gy in 20 Fx in arm A or HDR-BT of 15 Gy followed
by RT of 44 Gy in 20 Fx in arm B. Target volumes, treatment plans, gas-
trointestinal (GI) and genitourinary (GU) tox according to CTCAE v5.0
were analysed. Quality of life was assessed using the QLQ30, PR25 and
IPSS questionnaires. 23 patients in arm A and 18 in arm B received aFU
for 2 years.
Results: 25 patients were treated in each arm in two centres (FR and B).
In arms A and B 76% and 48% had unfavourable intermediate risk, 24%
and 36% high risk, respectively. Median boost volumes were 10.2 ml (arm
A) and 6.8 ml (arm B).
2-year grade 2 GU and GI tox was 8% and 4% in arm A. No grade 3 tox
was observed. At 12 months, two patients experienced grade 3 GI tox due
to multifactorial pathogenesis. 2-year grade 2 GU and GI tox was 17%
and 0% without any grade 3 tox in arm B. QoL analysis (response rate
50-60%) showed only small signicant dierences for bowel symptoms in
arms A and B and for sexual function in arm B. Median PSA at 2 years was
0.23ng/ml in arm A and 0.33 ng/ml in arm B.
Discussion: e 2-year FU shows good tolerability and QoL despite large
boost volumes. e Covid19 pandemic aected the response rate of the
QoL questionnaires.
Conclusions: e use of PSMA-PET in addition to mpMRI in focal
dose-escalated RT appears to be safe. However, radioproctitis demands
careful interdisciplinary management. PSMA-PET- and mpMRI-based
focal dose escalation in combination with stereotactic body radiotherapy
(SBRT) will be investigated in the currently recruiting HypoFocal phase
III trial.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts88
906
Lenvatinib plus Pembrolizumab as rst-line treatment in
patients with advanced renal cell carcinoma (aRCC) – real
world data from a retrospective multi-center analysis
Ramona Stelmach1; Katrin Schlack2; Clemens Mühle3; Christopher Darr4;
Stephanie Neuberger5; Mathias Reichert6; Marc Rehlinghaus7;
Luka Flegar8; Friedemann Zengerling9; Jozena Casuscelli10;
Alexander Cox11; Tim Nestler12; Timo Egenolf13; Bernhard Brehmer14;
Sonia Vallet15; Philipp Ivanyi16; Manuel Neuberger17; Pia Paenholz18;
Viktor Grünwald4; Stefanie Zschäbitz1
1Department of Medical Oncology, National Center for Tumor Diseases,
Heidelberg University Hospital, Heidelberg, Deutschland
2Department of Urology, University Hospital Münster, Münster, Deutschland
3Department of Urology, Klinikum Rechts der Isar, Technical University Munich,
München, Deutschland
4Department of Urology, University of Duisburg-Essen and German Cancer
Consortium (DKTK-)University Hospital Essen, Essen, Deutschland
5Department of Urology and Pediatric Urology, University Medical Center of
Johannes Gutenberg University, Mainz, Deutschland
6Department of Urology, University Medicine Göttingen, Göttingen,
Deutschland
7Department of Urology, University Hospital Düsseldorf, Düsseldorf,
Deutschland
8Department of Urology, Philipps-University Marburg, Marburg, Deutschland
9Department of Urology and Pediatric Urology, University Hospital Ulm, Ulm,
Deutschland
10Department of Urology, University Hospital, Ludwig Maximilian University of
Munich, München, Deutschland
11Department of Urology, University Hospital Bonn, Bonn, Deutschland
12Department of Urology, Federal Armed Services Hospital Koblenz, Koblenz,
Deutschland
13Department of Urology and Pediatric Urology, University Hospital Würzburg,
Würzburg, Deutschland
14Department of Urology, Diakonie Hospital, Schwäbisch Hall, Deutschland
15Department of Internal Medicine II, University Hospital Krems, Krems an der
Donau, Österreich
16Department of Hematology, Hemostasis, Oncology and Stem Cell
Transplantation, Claudia-von Schelling Comprehensive Cancer Center,
Hannover Medical School, Hannover, Deutschland
17Department of Urology and Urological Surgery, Medical Faculty Mannheim of
the University of Heidelberg, Mannheim, Deutschland
18Department of Urology, Uro-Oncology, Robot-Assisted and Reconstructive
Urologic Surgery, University of Cologne, Faculty of Medicine and University
Hospital Cologne, Köln, Deutschland
Background: Combinations of checkpoint inhibitors and tyrosine kinase
inhibitors are contemporary standard of care (SOC) in rst-line patients
with aRCC. Real-world evidence remains scarce. We investigated the
tolerability and ecacy of lenvatinib (LEN) and pembrolizumab (PEM)
under real-world conditions.
Methods: We retrospectively analyzed clinical data from patients with
aRCC who started LEN (20 mg OD) plus PEM (200 mg every 3 or 400
mg every 6 weeks) as SOC-rst-line treatment at 18 tertiary centers in
Germany and Austria between October 2020 and June 2023. Objective
response rate (ORR) was analyzed according to RECIST 1.1. Adverse
events (AE) were assessed by CTCAE v5.0.
Results: We included 134 patients in this analysis. Median age was 63
years (range 41-87). e majority of patients were male (71%). IMDC
risk group was favorable, intermediate, and poor in 27% 51% and 22%.
46% of patients did not meet the inclusion criteria of the CLEAR trial,
mainly due to CNS involvement, concomitant diseases or an ECOG ≥2.
AEs occurred in 90% of patients, with fatigue (49%), hypertension (39%)
and diarrhea (37%) as most common AE. AE grade ≥ 3 were seen in
52%. Steroids for immune-related AE were required in 25% of patients.
Interruption of at least one of the drugs due to toxicities was required
in 55% and dose reduction of LEN in 52% of patients. LEN-PEM was
permanently discontinued due to toxicities in 19%. ORR was 69%, with
9% achieving a complete remission. Primary progression was detected
in 10% of patients. At a median follow-up time of 10.9 months, 31%
experienced disease progression. Progression-free survival at 6 months
was 76% (95%CI: 68-84). 17% of patients died, most of them due to
progressive disease.
Discussion: Our results demonstrate ecacy and feasibility of LEN-PEM,
also in patients who are not considered trial-eligible. Objective response
and tolerability are comparable to the pivotal CLEAR trial. A limitation is
the short follow-up duration.
Conclusion: Our retrospective analysis supports the use of LEN-PEM as
SOC-rst-line treatment for patients with aRCC.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
919
Early-detected vs. otherwise-detected prostate cancer:
5-years results from the VERSUS study
Frank König1; Rolf Harald Eichenauer2; Manfred Johannsen3;
Robert Schönfelder4; Jörg Klier5; Jörg Schröder1; Elke Hempel6;
Christian Doehn7
1ATURO, Berlin, Deutschland
2Urologikum Hamburg, Hamburg, Deutschland
3Urologie Johannsen & Laux, Berlin, Deutschland
4Urologie Schönfelder & Strasser, Hamburg, Deutschland
5UPK, Köln, Deutschland
6SMGF, Berlin, Deutschland
7Urologikum Lübeck, Lübeck, Deutschland
Background: Since May 2018, members of d-uo have been documenting
urologic tumor cases as part of the prospective VERSUS study. We asked
ourselves whether there are dierences between early-detected and other-
wise-detected patients with prostate cancer regarding age and tumor stage
at initial diagnosis.
Methods: By April 2023, 16,916 patients with an initial diagnosis of uro-
logic tumor disease were documented. Prostate cancer was present in
10,664 patients (63.0%).
Result: Prostate cancer was early-detected in 5.543 patients (52.0%) and
by another route in 5.331 patients (48.0%). e median age was 69.8
years in patients with early-detected and 70.8 years in patients with oth-
erwise-detected prostate cancer. e distribution of UICC stages were
(early-detected/otherwise-detected): UICC I: 63.8%/51.1%; UICC II:
18.6%/16.7%; UICC III: 91.1%/8.6%; UICC IV: 8.5%/16.6%.
Discussion: We herein present current real world data from Germany
demonstrating that patients with early-detected prostate cancer are
younger than patients with otherwise-detected prostate cancer. However,
patients with early-detected prostate cancer show more favorable tumor
stages.
Conclusion: Our nding may have impact on early diagnosis as well as
staging and therapy of patients with prostate cancer.
Disclosure Statement: e authors declare no conict of interest.
922
Symptomatic vs. non-symptomatic renal cell carcinoma:
5-years results from the VERSUS study
Manfred Johannsen1; Jörg Klier2; Frank König3; Robert Schönfelder4;
Rolf Harald Eichenauer5; Jörg Schröder3; Elke Hempel6; Christian Doehn7
1Urologie Johannsen & Laux, Berlin, Deutschland
2UPK, Köln, Deutschland
3ATURO, Berlin, Deutschland
4Urologie Schönfelder & Strasser, Hamburg, Deutschland
5Urologikum Hamburg, Hamburg, Deutschland
6SMGF, Berlin, Deutschland
7Urologikum Lübeck, Lübeck, Deutschland
Background: Since May 2018, members of d-uo have been document-
ing urologic tumor cases as part of the prospective VERSUS study. We
asked ourselves whether there are dierences between symptomatic and
non-symptomatic patients with renal cell carcinoma regarding age and
tumor stage at initial diagnosis.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 89
Methods: By April 2023, 16,916 patients with an initial diagnosis of uro-
logic tumor disease were documented. Renal cell carcinoma was present
in 1,306 patients (7.7%). ere were 909 men (69.6%) and 397 women
(30.4%).
Result: Renal cell carcinoma was diagnosed due to symptoms in 333
patients (25.5%) and by another route in 973 patients (74.5%). e
median patient age, with no relevant gender dierence, was 65.0 years
in patients with symptoms and 66.3 years in patients without symptoms.
e distribution of UICC stages were (symptomatic patients/non-symp-
tomatic patients): UICC I: 51.3%/72.9%; UICC II: 9.1%/8.8%; UICC III:
18.3%/13.0%; UICC IV: 21.3%/5.4%.
Discussion: We herein present current real world data from Germany
demonstrating that patients with renal cell carcinoma and symptoms do
not dier in age from patients with any other cause of diagnosis. However,
patients with symptoms show less favorable tumor stages.
Conclusion: Our nding may have impact on early diagnosis as well as
staging and therapy of patients with renal cell carcinoma.
Disclosure Statement: e authors declare no conict of interest.
Geriatric Oncology
183
Frail – B: A prospective interdisciplinary trial to evaluate a
systematic two-step frailty screening before gynaecological
oncology surgery
Katharina Gillen1; Valerie Linz2; Marcus Schmidt2; Walburgis Brenner2;
Annette Hasenburg2; Marco Battista2
1Jung-Stilling-Krankenhaus, Diakonie Klinikum, Siegen, Deutschland
2Universitätsmedizin Mainz, Mainz, Deutschland
Purpose: Frailty as an underdiagnosed multidimensional age-related syn-
drome has grown in importance for the need of a better understanding of
the health and functional status of older persons. is study investigates
the impact of a standardized, two-step multidisciplinary frailty assess-
ment concerning the perioperative outcome in women with gynaecolog-
ical malignancies.
Methods: In this prospective clinical trial, all women with gynaecolog-
ical malignancies regardless of the histological type and previous treat-
ments have been systematically screened preoperatively at the University
Medical Centre Mainz since May 2020. All participants take part in the
two-step frailty assessment with selected screening tools (Screening I+II),
peripheral blood results as well as a comprehensive geriatric assessment
(CGA) if necessary. e main outcome measures are the association of
the preoperatively evaluated frailty status with perioperative laboratory
results, intraoperative surgical parameters, the incidence of immediate
postoperative in-hospital complications and the oncological outcome.
Results: is is an ongoing trail. So far, 158 patients have been recruited
for the study including patients with ovarian cancer (n= 56; 35.4%), endo-
metrial cancer (n=52; 32.9%), cervical cancer (n=7; 4.4%), vulvar and
vaginal cancer (n=33; 20.9%), and other gynaecological tumours (n=10;
6.3%). 57 (36.1%) patients have been classied as G8-frail according to the
G8 geriatric screening tool and underwent the second frailty assessment.
Discussion: To ensure a possible operationalization of frailty, we have
initiated a two-step frailty assessment in our department. is screening
helps to identify a signicant proportion of women who should receive
perioperative optimization of their global health status to provide their
best individual surgical treatment
Conclusion: A standardized frailty assessment especially for elderly
women with gynaecological cancer might identify patients with worse
prognoses and with a signicant high rate of severe postoperative
complications.
Disclosure Statement: e authors declare no conict of interest.
187
Association of functional status, blood biomarkers and overall
survival in older patients with lymphoma – a monocentric,
retrospective study
Antje Jensch1; Eva Mennig1; Susanne Walz1; Simone Neumaier1;
Ruth Elisa Eyl-Armbruster1; Markus Knott1,2; Alexander Friedl3;
Ralf Lobmann3; Pascale Regincos2; Roswitha Uibeleisen2; Gerald Illerhaus2
1Stuttgart Cancer Center (SCC) - Tumorzentrum Eva Mayr-Stihl, Klinikum
Stuttgart, Stuttgart, Deutschland
2Department of Hematology, Oncology and Palliative Care, Klinikum Stuttgart,
Stuttgart, Deutschland
3Department of Endocrinology, Diabetology and Geriatrics, Klinikum Stuttgart,
Stuttgart, Deutschland
Background: Elderly oncological patients constitute an increasing
amount at Klinikum Stuttgart. To investigate their therapy resources, a
geriatric-hematologic assessment (GA) was introduced. We aimed to
evaluate if functional status according to GA relates to blood biomarkers
and overall survival of lymphoma patients.
Methods: e GA consists of standardized physical and neurocognitive
diagnostic instruments that provide a functional status (“t”; “vulnera-
ble”; “frail”). For the analyses, data from 2009 to 2022 was used. Patients
were selected by disease entity (ICD C81-88, C90, C96) and functional
classication. Survival times were evaluated using Kaplan-Meier curves
for subgroups of dierent levels of haemoglobin (Hb), albumin, lactate
dehydrogenase (LDH) and c-reactive protein (CRP).
Result: Between 2009 and 2022, GA was performed on 286 patients diag-
nosed with lymphoma with a median age of 77 years (60-95). Functional
status was available for 255 lymphoma patients (118 (46%) “t, 109 (43%)
“vulnerable, 28 (11%) “frail”). “Fit” patients with lower Hb values had a lower
median survival time (MST) (low: 2.9 years, normal: 8.5 years). Elevated
CRP values were also associated with a lower MST in “t” patients (high:
2.8 years, normal: 7.0 years). Additionally, “t” and “vulnerable” patients
with high LDH values showed a lower MST compared to normal LDH val-
ues (high: 3.7 years, normal: 6.8 years and high: 0.9 years, normal: 2.5 years,
respectively). Albumin was not reasonably evaluable due to the small num-
ber of values available. Overall, lower functional status was associated with
lower proportions of normal values for all biomarkers except Hb.
Discussion: Functional status according to GA is reected in blood bio-
markers of lymphoma patients and, to some extent, in survival probability.
is is especially true for “t” patients.
Conclusion: e GA is a useful clinical tool to map overall health resources
of older oncological patients before starting therapy. Nevertheless, high
CRP and high LDH are associated with a decreased MST despite “t” status.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts90
Gynecologic Cancer
78
Get us to know
Andrea Krull
Gynäkologische Krebserkrankungen Deutschland e.V., Neumünster,
Deutschland
Association: Gynecological Cancer Germany e.V. / Focus OC
Association and VOICE for woman with abdominal cancers!
Five abdominal cancers - one voice !
Aim: GynKD e.V. and doctors - together for better treatment, prevention,
aercare and knowledge.
Key words: Abdominal, Ovarian Cancer, gyn.cancer, accompaniment,
enlightenment, networks, QoL, cooperation, empowerment
Introduction: Association: Gyn. Cancers Germany e.V. (GynKD e.V.) is
well known Patient Advocate Organisation which enlightens patients,
empowers them to improve quality of life and ll their need for informa-
tion and exchange. We raise awareness, knowledge, prevention.
Our vision: To empower and inform - to give fundamental knowlege/
information within Germany, Austria and Switzerland.
Association: Is strong voice in Germany, within doctors, stakeholders,
medical organisations, media and federal authorities. Since 2020 expanded
to support those aected by cervical-, vulva and endometrial cancer.
Background: Ovarian Cancer incidens: 7800 women / year. Other gyn.
cancer: 28.703 woman/year - Complete mortality : Germany : approx.
20.503 women (source 1).
OUR Association - wants to introduce itself with poster and presentation
to show its misssion, projects, services to strengthen patients / independ-
ent research!
Listen to our presentation how to support best abdominal cancer patients
Vision: Information, Collaboration, Exchange, Empowerment
ere is an urgent need of signicant support in care, information and
education for abdominal cancer patients.
e number of gynecological patients should be reduced/earlier
detected.
prevention, treatment, aercare should be uniformly treated in com-
petence centers, practicing GPs and gynecologists should be better
focused on sympthomes and trained in communication.
public and young women should be entlightend.
high need of understandable information: Prerehabilitation, understand-
able trials, more/better terminal care, better communication and support.
Disclosure Statement: e authors declare no conict of interest.
107
First Interim Analysis of the SCOUT-1 Study (NOGGO ov54,
NCT04830709): A Non-Interventional Study to evaluate
Treatment Patterns and Longterm Outcome in Patients with
Newly Diagnosed Advanced Ovarian Cancer
Klaus Pietzner1,2; Elena Ioana Braicu1,2; Pauline Wimberger2,3;
Jessika Goldmann4; Karol Kubiak5; Nikolaus de Gregorio6; Julia Radosa7;
Bahriye Aktas2,8; Angelika Ober9; Cosima Brucker10;
Philipp Meyer-Wilmes2,11; Badrig Melekian12; Jacqueline Sagasser2,13;
Dagmar Guth14; Andreas Schnelzer15; Svetlana Tchaikovski16;
Björn Lampe17; Svenja Diemert18; Jalid Sehouli1,2
1Department of Gynecology European Competence Center for Ovarian Cancer,
Campus Virchow-Klinikum, Charité Medical University, Berlin, Deutschland
2North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin,
Deutschland
3Department of Gynecology and Obstetrics, University Hospital Carl Gustav
Carus, TU Dresden, Dresden, Deutschland
4Department of Obstetrics and Gynecology, DRK Kliniken Berlin, Berlin,
Deutschland
5Department of Obstetrics and Gynecology, St. Franziskus-Hospital, Münster,
Deutschland
6Department of Obstetrics and Gynecology, SLK Kliniken, Heilbronn,
Deutschland
7Department of Gynecology, Obstetrics and Reproductive Medicine, University
Medical School of Saarland, Homburg/Saar, Deutschland
8Department of Gynecology, University of Leipzig Medical Center, Leipzig,
Deutschland
9Department of Obstetrics and Gynecology, St Vincenz Hospital Limburg,
Limburg, Deutschland
10Paracelsus Medical University, University Womens Hospital, Klinikum
Nürnberg, Nürnberg, Deutschland
11Department of Gynecology and Obstetrics, University Hospital RWTH Aachen,
Aachen, Deutschland
12Department of Obstetrics and Gynecology, St. Marien-Krankenhaus Siegen,
Siegen, Deutschland
13Department of Gynecology and Obstetrics, University Hospital Augsburg,
Augsburg, Deutschland
14Gynecologic Oncology, Praxis Dr. med. Dagmar Guth, Plauen, Deutschland
15RoMed Klinikum Rosenheim, Department of Obstetrics and Gynecology,
Rosenheim, Deutschland
16Department of Gynecology and Obstetrics, Otto-Von-Guericke University,
Magdeburg, Deutschland
17Department of Gynecology and Obstetrics, Florence Nightingale Hospital,
Düsseldorf, Deutschland
18AstraZeneca, Hamburg, Deutschland
Background: Current standard of care for advanced ovarian cancer
(OC) consists of upfront surgery, with the goal of complete macroscopic
resection, platinum-based chemotherapy (pCTX) and maintenance ther-
apy (MTX) with poly(ADPribose) polymerase inhibitors (PARPi) or
bevacizumab as monotherapy or in combination. e prospective, non-
interventional SCOUT-1 study (NOGGO ov54, NCT04830709) was initi-
ated to assess treatment patterns including MTX and long-term outcome
in patients with newly diagnosed advanced OC in Germany.
Methods: 750 patients providing written informed consent, with com-
pleted surgery (if applicable), eligible for pCTX, tested for BRCA1/2
mutations (BRCAm) and willing/able to complete PROs electronically, are
planned to be enrolled and followed for up to 7 years.
Aim of the study is to analyze cohorts of special interest (PARPi MTX,
bevacizumab MTX, no MTX). Interim analyses were dened at 175, 250
and 375 enrolled patients, followed for 6 months, to assess the distribu-
tion across cohorts, safety and gain rst insight into characteristics of
patients.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 91
Result: First 175 patients were enrolled between June 15th 2021 and
November 20th, 2022. Of these, 159 were eligible and included in the
analysis (median age 60 years, ECOG ≤1: 98.7%; concomitant disease:
72.3%). Most tumors were in FIGO stage III (74%) and of serous his-
tology (92%). BRCAm were detected in 23.3% and non-BRCA HRD
positivity in 45.2% of tumours tested. 91% of patients underwent
debulking surgery, 98% used carboplatin and paclitaxel as 1L pCTX and
91% received targeted therapy. Adverse drug reactions were consistent
with known tolerability prole of substances used in the 1L and mostly
related to MTX.
Conclusion: First SCOUT-1 data reect current real-world practice and
transfer from phase III trials into clinical routine. Future analysis should
dene the barriers to improve the quality of care.
Disclosure Statement: e authors declare the following:
154
Impact of preoperative determined global health assessment
tools on the outcome of patients with vulva and vaginal
cancer – results of the prospective, observational,
single-center study (FRAIL-B)
Katharina Gillen1; Valerie Catherine Linz2; Emma Rosemarie Liebau2;
Maria Schröder2; Wolfang Weikel2; Alexander Seeger2; Roxana Schwab2;
Marcus Schmidt2; Annette Hasenburg2; Marco Battista2
1Jung-Stilling-Krankenhaus, Diakonie Klinikum, Siegen, Deutschland
2Universitätsmedizin Mainz, Mainz, Deutschland
Purpose: Frail-B is a prospective, observational, single-center study
to assess the impact of pre-operatively determined frailty status on the
outcome of patients with gynecological malignancies. In this subgroup-
analysis, we describe the results for women aected by vulva cancer (VC)
and vaginal cancer (VaC).
Methods: Patients 60 years and older with VC and VaC, being operated
at the University Medical Center Mainz from June 2020 until June 2023,
entered in these analyses. ey were assessed with a two-step frailty algo-
rithm using the G8 geriatric screening questionnaire (G8-Score) and the
LEE-Schonberg prognostic index (LEE-Index).
Results: 31 patients (three with VaC) were included. Mean age was 73.5
years (±7.2 years). 16 patients (51.6%) were classied as G8-frail and 14
(45.2%) had an estimation of life <15% for the next four years according to
the LEE-Index. ree (9.7%) patients received an individual, less radical
surgical approach out of them all were preoperatively classied as G8-frail
(p=0.078) or LEE-frail (p=0.041). Frail patients in total were associated
with a signicantly decrease of 2-years-overall-surival (G8-Score: 53.8%
vs. 100.0%, p=0.041 and LEE-Index: 53.0% vs. 100.0%, p=0.036).
Discussion: Frailty as a multidisciplinary aging-related syndrome of
physical decline characterized by an excessive vulnerability to endog-
enous and exogenous stressors with adverse health outcomes. Vulvar
cancer is an uncommon disease that primarily aects older women.
Oncologic prognosis in the elderly is signicantly impaired due to mul-
tiple reasons. Identifying patients being not frail using validated tools
may help to identify patients requiring standard surgical care. Our
results underline the necessity of a preoperative standardized frailty
assessment in VC and VaC.
Conclusions: Frailty assessment with standardized screening-tools prior
to surgical treatment may assist to identify elderly patients with VC and
VaC in whom the standard surgical approach may be benecial.
Disclosure Statement: e authors declare no conict of interest.
270
Phase 3 MIRASOL (GOG 3045/ENGOT-ov55) Trial:
Mirvetuximab Soravtansine (MIRV) Prolongs Overall Survival
vs Investigator’s Choice Chemotherapy (IC) in Platinum-
Resistant Ovarian Cancer (PROC) with High Folate Receptor-
Alpha (FRα) Expression
Felix Hilpert1; Philipp Harter2; Domenica Lorusso3; Gottfried. E. Konecny4;
Susana Banerjee5; Nicoletta Colombo6; Yuemei Wang7; James Stec7;
Michael Method7; Toon Van Gorp8; Kathleen Moore9;
Nikolaus de Gregorio10
1Krankenhaus Jerusalem Hamburg, & AGO Study Group, Hamburg, Deutschland
2Kliniken Essen-Mitte gGmbH & AGO Study Group, Essen, Deutschland
3Fondazione Policlinico Universitario A Gemelli Istituto di Ricerca e Cura a
carattere scientico (IRCCS), Rom, Italien
4UCLA Jonsson Comprehensive Cancer Center, Los Angeles, USA
5Royal Marsden Hospital, London, United Kingdom
6European Institute of Oncology IRCCS and University of Milan-Bicocca,
Mailand, Italien
7ImmunoGen, Inc., Waltham, USA
8Leuven Cancer Institute & BGOG, Leuven, Belgien
9University of Oklahoma Health Sciences Center, Oklahoma City, USA
10Klinikum am Gesundbrunnen, SLK-Kliniken Heilbronn GmbH & AGO Study
Group, Heilbronn, Deutschland
Background: Mirvetuximab soravtansine (MIRV), an antibody-drug con-
jugate targeting FRα. MIRASOL is a randomized phase 3 trial of MIRV vs
standard-of-care chemotherapy in patients (pts) with PROC
Methods: 453 PROC pts with high FRα expression (Roche FOLR1 Assay)
were randomized 1:1 to MIRV 6 mg/kg, adjusted ideal body weight, Day
1 of a 21-day cycle or IC: paclitaxel, pegylated liposomal doxorubicin, or
topotecan. e primary ecacy endpoint was progression-free survival
(PFS) by investigator (INV), key secondary endpoints ORR, and overall
survival (OS), other endpoints included safety and tolerability.
Result: 227 pts were randomized to the MIRV; 226 to the IC . Baseline
characteristics were well balanced across arms; 14% of pts had one, 39%
two, and 47% three prior lines of therapy (PLOT); 62% received prior bev;
and 55% received prior PARPi therapy. e study met its primary and
key secondary endpoints with statistically signicant results in PFS 5.62
months vs. 3.98 months (PFS HR 0.65 [0.52, 0.81]); ORR 42.3 vs. 15.9;
and OS 16.46 months vs. 12.75 months (OS HR 0.67 [0.50, 0.88] favor-
ing MIRV. In subset analyses, pts with 1 or 2 PLOT, PFS HR was 0.61
(0.45, 0.81); and 3 PLOT, PFS HR was 0.71 (0.52, 0.98), the OS HR was
0.66 (0.45, 0.98) for 1 or 2 PLOT; and 0.65 (0.43, 0.96) for 3 PLOT. In pts
with prior PARPi, PFS HR was 0.58 (0.43, 0.78) and ORR 45% vs 17%. In
PARPi naïve, PFS HR was 0.74 (0.54, 1.03) and ORR 40% vs 14%.
e adverse event (AE) prole of MIRV was consistent with prior reports:
predominantly low-grade ocular (MIRV vs IC all grade 56% vs 9%; grade
3+ 14% vs 0%) and gastrointestinal events (MIRV vs IC all grade 70% vs
66%; grade 3+ 13% vs 15%). Compared with IC, MIRV was associated
with lower rates of grade 3+ treatment-emergent AEs (42% vs 54%), seri-
ous AEs (24% vs 33%), and discontinuations due to TEAEs (9% vs 16%).
Conclusion: MIRV is the rst treatment to demonstrate a PFS and OS
benet in PROC compared to IC with demonstrate consistent benet
across subgroups. e ecacy data, along with the well-characterized
safety prole, position MIRV as a new, standard of care for pts with FRα
positive PROC.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts92
290
FRAIL-B: Preoperative G8 geriatric screening tool for ovarian
cancer patients to identify women with a worse perioperative
outcome
Katharina Gillen1; Valerie Catherine Linz2; Marcus Schmidt2;
Annette Hasenburg2; Marco Battista2
1Jung-Stilling-Krankenhaus, Diakonie Klinikum, Siegen, Deutschland
2Universitätsmedizin Mainz, Mainz, Deutschland
Background: Frail patients with ovarian cancer (OC) should be identi-
ed preoperatively to reduce their risk of adverse surgical outcomes. We
present rst results of a systematic, preoperative frailty screening of OC
patients regarding their perioperative outcome.
Methods: OC patients regardless of the previous treatments or the his-
tological type were screened preoperatively by the G8 geriatric screening
tool. If a patient was considered to be G8-frail (cut-o: ≤ 14points), multi-
ple geriatric assessment tools followed. e main outcome measures were
the relationship between perioperative laboratory results, intraoperative
surgical parameters and the incidence of immediate postoperative in-
hospital complications with the preoperative frailty status.
Results: So far, 42 OC patients treated with laparotomy for tumour
debulking/extirpation were included at the University Medical Centre
Mainz between May 2020 and May 2023. Mean age was 69.2 years. Most
of the patients (71.4%) hadadvanced stage OC (≥ FIGO IIB). e G8-frail
cohort seemed to have a higher prevalence of polypharmacy (p=0.098)
and more surgical revisions (21.1 vs. 4.3%; 51 p=0.158) than the G8-non-
frail cohort. Furthermore, the G8-frail cohort appeared to have a longer
mean hospital stay (10.7 vs. 17.7 days; p=0.096) and appeared to be read-
mitted to hospital more oen than the G8-non-frail cohort (15.8 vs. 8.7%;
p=0.096). One patient in each cohort died during hospital stay.
Discussion: Preoperative frailty assessment with the G8 geriatric screen-
ing tool for elderly women with OC might indicate polypharmacy, a lon-
ger hospital stay and a higher rate of readmission. Further results will be
expected soon.
Conclusion: Preoperative determined global health status using G8 geri-
atric screening tool might identify elderly patients beeing at high risk for
severe complications.
Disclosure Statement: e authors declare no conict of interest.
314
Surgical resection based on ontogenetic cancer eld theory
for cervical cancer: 10-year updated results of the MMR study
Laura Weydandt; Benjamin Wolf; Nadja Dornhöfer; Bahriye Aktas
Universitätsklinikum Leipzig, Leipzig, Deutschland
Background: In the MMR study we aimed to determine whether surgical
treatment that accounts for stage-associated, ontogenetic cancer elds and
their associated lymphoid tissues results in locoregional tumor control
without the need for adjuvant radiotherapy.
Methods: e Leipzig School Mesometrial Resection Study (MMR
study) is an ongoing, prospective, single-center, observational cohort
study including patients with primary cervical cancer. All study partici-
pants undergo either total or extended mesometrial resection (TMMR or
EMMR) and therapeutic lymph node dissection. Because this treatment
strategy enables surgical removal of all locoregional at-risk tissues, no
adjuvant radiotherapy is necessary, even in the presence of established risk
factors. For this updated analysis, we identied patients in our study data-
base with primary cervical cancer staged IB1 – IIA2 according to the 2009
International Federation of Gynecology and Obstetrics staging system.
Result: Between October 16, 1999, and December 16, 2020, 420 patients
were treated per protocol and followed up for a median of 136 months
(IQR 77-190). 329 patients (78.3%) had stage IB1, 58 (13.8%) stage IB2,
24 (5.7%) stage IIA1 and 9 (2.1%) stage IIA2 disease. e nodal status was
pN0 in 349 (83.1%) patients and pN1 in 71 (16.9%) of the cases. 10-year
overall survival was 90.2% (95% condence interval [CI] 87.1-93.4) and
recurrence-free survival was 90.6% (95% CI 87.8-93.6). Stratied for
lymph node status 10-year overall survival was 91.7% (95% condence
interval [CI] 88.5-95) for pN0 and 83.2% (95% condence interval [CI]
74.6-92.9) for pN1. Recurrence-free survival was 93.8% (95% CI 91.2-
96.5) for pN0 and 75.4% (95% CI 65.9-86.3) for pN1.
Conclusion: Despite dispense of adjuvant radiotherapy, patients treated
with total or extended mesometrial resection with therapeutic lymph
node dissection have excellent survival outcomes.
© 2023American Society of Clinical Oncology, Inc. Reused with permission.
is abstract was accepted and previously presented at the 2023ASCO Annual
Meeting. All rights reserved.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
323
Is this the downfall of Gynecologic Oncology? Using the
example of outpatient specialist care (ASV)–gynecologic
tumors without subspecialization
Theresa Link; Pauline Wimberger
Uniklinik Dresden/Gynäkologie, Dresden, Deutschland
Background:
e future of the gynecologic oncology is in jeopardy. Gynecologic sur-
geries performed by general surgeons and systemic treatment of gyneco-
logical cancers by medical oncologist are some examples.
e membership in the ASV for gynecological tumors without subspe-
cialization requires successful subspecialization in Gynecologic Oncology
for gynecologists, but majority of these spend most of their time in the
operating room in an impatient setting. A gynecologist without this sub-
specialization is explicitly excluded from ASV even with specialization for
systemic tumor therapy if passed aer December 2015.
Methods: Based on the homepage asv-servicestelle.de all existing ASV
teams – gynecologic tumors without subspecialization were listed, core
teams were counted by speciality and team leader were captured by
profession.
All ASV teams were contacted via email and all chairs of the
Landesärztekammern of the respective state were asked to provide num-
bers of doctors with successful exam for Gynecologic Oncology in 2021
and 2022.
Result: In total, there are 116 ASV teams listed for gynecological tumors
without subspecialization in Germany. Overall, there are only 320 (23%)
gynecologists, 510 (36%) internists and 551 (39%) radiation oncologists
included in the core teams. But 66% of the team leaders are gynecologists.
Up to now 14 federal states provided numbers of successful examens
for Gynecologic Oncology. In 2021 45 gynecologists passed the examen
mainly in Bavaria and Baden-Württemberg. 10 states reported only 0 to
3 examens per year.
More numbers will be provided at the congress.
Discussion: Many standards in Gynecologic Oncology worldwide were
set by gynecologists. With the rapid progress and rising complexity, a
focus on systemic treatment by highly specialized physicians is more than
necessary.
Conclusion: In regard to the low numbers of gynecologists in the ASV
and the low numbers of exams it is very likely to lose the systemic treat-
ment in gynecology.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 93
355
GynTect® Methylation Markers detect recurrent disease in
patients treated for CIN3 with high sensitivity and specicity
in a retrospective case-control study
Heike Hoyer1; Cornelia Scheungraber2; Grit Mehlhorn3; Ingke Hagemann4;
Sarah Scherbring5; Linn Wölber6; Annett Petzold7; Kristina Wunsch8;
Martina Schmitz8; Monika Hampl9; Gerd Böhmer10; Peter Hillemanns11;
Ingo B. Runnebaum7; Matthias Dürst7
1Institut für Medizinische Statistik, Informatik und Datenwissenschaften,
Universitätsklinikum Jena Jena, Deutschland
2Frauenarztpraxis Dr. med. Cornelia Scheungraber Jena, Deutschland
3Frauenarztpraxis PD Dr. med. Grit Mehlhorn Erlangen, Deutschland
4abts+partner Partnerschaftsgesellschaft Kiel, Deutschland
5Fachärzte für Frauenheilkunde und Geburtshilfe Braunschweig, Deutschland
6Klinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf Hamburg,
Deutschland
7Klinik und Poliklinik für Frauenheilkunde und Fortpanzungsmedizin,
Universitätsklinikum Jena Jena, Deutschland
8Ongnostics GmbH Jena, Deutschland
9Frauenklinik, Universitätsklinikum Düsseldorf Düsseldorf, Deutschland
10Institut für Zytologie und Dysplasie (IZD) Hannover, Deutschland
11Klinik für Frauenheilkunde und Geburtshilfe, Medizinische Hochschule
Hannover (MHH) Hannover, Deutschland
Background: Post-treatment follow-up in women with CIN3 is manda-
tory due to relapse in up to 10% of patients. Standard follow-up based on
hrHPV-DNA/cytology co-testing has high sensitivity but limited speci-
city. e aim of our case-control study was to evaluate the performance
of the methylation test GynTect® for the detection of recurrent CIN2/3
during follow-up.
Methods: Residual clinical material from an observational study with a
focus on HPV/cytology co-testing was analysed (PMID34282754). We
studied a sample of 48 patients (median age 31 years) comprising 17 cases
with recurrent CIN2/3 diagnosed within 24 months and 31 controls. All
of them had at least one follow-up visit. DNA from cervical scrapes at
baseline (before CIN3 surgery) and follow-up visits were analysed for
13hrHPV types and the GynTect® methylation status.
Result: Overall 15 of 48 patients were GynTect-negative at baseline. Of the
33 GynTect-positive patients at baseline 12 were diagnosed with recurrent
disease. Two of these patients were neither hrHPV- nor GynTect-positive
during follow-up. One patient was hrHPV-positive but GynTect-negative
and 9 patients were hrHPV- and GynTect-positive during follow-up.
Sensitivity was not signicantly dierent for GynTect (75%, 95% CI 46%-
92%) and hrHPV (83%, 95% CI 55%-96%) (McNemar p=1.00). Two of
21 patients who were GynTect-positive at baseline but without evidence
for recurrent disease were both hrHPV- and GynTect-positive during fol-
low-up. Six patients were hrHPV-positive but GynTect-negative and 13
patients were negative for both tests. Specicity was signicantly higher
for GynTect (90%, 95% CI 71%-98%) compared to hrHPV (62%, 95% CI
40%-80%) (McNemar p=0.03).
Conclusion: For initially GynTect-positive patients both hrHPV and
GynTect® assays detect recurrent disease with similar sensitivity but the
GynTect® assay has a signicantly higher specicity. A future study will
have to show whether cytology/GynTect® co-testing will out-perform
cytology/hrHPV co-testing in post-treatment surveillance for this sub-
group of CIN3 patients.
Disclosure Statement: e authors declare the following: MD is founding
member, advisory board member and minority shareholder of oncgnostics GmbH.
KW is employed as an R&D scientist at oncgnostics GmbH. MS is founding
member, CSO and minority shareholder of oncgnostics GmbH.
426
Inuence of the molecular subtype of epithelial ovarian
cancer (EOC) on MDSC induction
Lena Marie Wahl1; Gabriele Diamante1; Daniel Rapp2; Kerstin Kitt3;
John Park3; Klaus-Michael Debatin1; Jan Lewerenz2; Gudrun Strauss1
1University Medical Center Ulm, Department of Pediatrics and Adolescent
Medicine, Ulm, Deutschland
2University Medical Center Ulm, Department of Neurology, Ulm, Deutschland
3Boehringer Ingelheim GmbH KG & Co, Biberach, Deutschland
Background: Epithelial ovarian cancer (EOC) is characterized by high
malignancy and poor anti-tumor immunity. EOC is classied into 5
dierent molecular subtypes (Mes, Epi-A, Epi-B, Stem-A and Stem-B).
Myeloid-derived suppressor cells (MDSCs) as part of the tumor micro-en-
vironment (TME) strongly contribute to immunosuppression and tumor
immune escape. ey are signicantly increased in OC patients and indic-
ative for malignancy and treatment refractory. erefore, an association
between OC subtypes and MDSC induction and function might help
identifying biomarkers of low immunogenic tumor subtypes.
Methods: OC cell lines with dened molecular subtypes and primary
tumor samples, for which the subtype is dened by Nanostring analy-
sis, are used in MDSC induction assays by co-culturing tumor cells with
PBMCs. We aim to investigate MDSC numbers and suppressive ability
and the expression of MDSC inducing factors among molecular subtypes
of OC.
Results: Co-culture of PBMCs with OC cell lines of dierent molecular
subtypes showed that only the Mes phenotype of OC, associated with the
poorest outcome, eciently induced MDSCs while all other subtypes are
poor MDSC inducers. M-MDSCs are the prominent MDSC fraction and
transwell assays indicated that MDSC induction requires cell-cell contact.
is is further supported as Mes OC cells do not express elevated levels
of pro-inammatory factors described to activate MDSCs. Mes-induced
MDSCs eciently inhibit T-cell proliferation while the suppressive
function of MDSCs induced by other molecular subtypes is still under
investigation.
Discussion: e Mes phenotype of OC could be associated to increased
MDSC induction. Studies with primary tumor cells and PBMCs will clar-
ify whether this association can be conrmed with patient material.
Conclusions: Dening an association between molecular tumor markers
and the cellular composition of the TME might help to identify patients
with poor anti-tumor immunity and thereby impact treatment strategies.
Disclosure Statement: e authors declare the following: John Park und Kerstin
Kitt stehen in einem Beschäigungsverhältnis mit Boehringer Ingelheim
Pharma GmbH & Co. KG. Lena Wahl und Daniel Rapp werden zum Teil über
Forschungsunterstützung von Boehringer Ingelheim Pharma GmbH & Co. KG
bezahlt.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts94
450
Managing Immune-Related Adverse Events Following
Immune-Checkpoint Therapy in Patients with Gynecologic
Cancer – A Survey from Germany, Austria, and Switzerland
Maximilian Riedel1,2; Helene Herrmann1,3; Thomas Bartl1,4;
Anna-Maria Rossner1,5; Anna Tatzber1,6; Chiara Flethe1,7; Dario Zocholl8;
Barbara Schmallfeldt9; Jalid Sehouli1,10; Klaus Pietzner1,10
1Young Academy of Gynecologic Oncology (JAGO), Nord-Ostdeutsche
Gesellschaft für Gynäkologische Onkologie (NOGGO), Berlin, Deutschland
2Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technical
University Munich, München, Deutschland
3Department of Gynecology and Obstetrics, Division of Gynecologic Oncology,
Hospital Waldfriede Berlin, Berlin, Deutschland
4Department of Obstetrics and Gynecology, Division of General Gynecology
and Gynecologic Oncology, Comprehensive Cancer Center, Medical University
Vienna, Wien, Österreich
5Department of Gynecology and Obstetrics, Gynecologic Oncology, St. Josefs-
Hospital Wiesbaden GmbH, Aliated Hospital of Medical University of Mainz,
Mainz, Deutschland
6Department of Gynecology with Breast Center, Charité Mitte, Medical
University Berlin, Berlin, Deutschland
7Department of Gynecological Oncolocy, Charité Campus Virchow, Charité
Medical University, Berlin, Deutschland
8Charité Medical University Berlin, Corporate member of Freie Universität
Berlin and Humboldt-Universität zu Berlin, Institute of Biometry and Clinical
Epidemiology, Berlin, Deutschland
9Department of Gynaecology and Gynaecologic Oncology, University Medical
Center Hamburg-Eppendorf, Hamburg, Deutschland
10Department of Gynecology with Center for Oncological Surgery, Virchow
Campus Clinic, Charité Medical University, Berlin, Deutschland
Background: e application of immune-checkpoint therapy has gained
momentum in the treatment of gynecological malignancies in recent
years. is study aimed to explore gynecologists’ viewpoints and experi-
ences concerning immune-checkpoint inhibitor therapy in gynecological
oncology and tried to unravel its current implementation, challenges, and
potential approaches for managing side eects.
Methods: A questionnaire was distributed via diverse channels to physi-
cians collecting data from October 2022 to May 2023.
Result: e study included 221 participants. A majority specialized in
gynecological oncology (59.1%), occupying various clinical positions:
residents (41.8%), specialized physicians (19.5%), consultants (31.8%),
and clinical directors (5.9%). Most were aliated with university hospitals
(54.1%), followed by accredited tumor centers (30.73%), ambulant prac-
tices (10.1%), and non-accredited clinics (4.1%). Participants reported
an average of 26 patients treated with immune-checkpoint inhibitors
throughout their clinical careers. Side eects under immune-checkpoint
therapy varied, with thyroiditis, skin reactions, and pneumonitis being the
most common. Over 80% have admitted or referred patients for inpatient
treatment due to side eects; severe side eects necessitating intensive
care (33.6%) or patient mortality (7.4%) were also observed. e aware-
ness of long-term eects was signicant, with a majority of participants
inquiring about immune-mediated side eects during post-treatment fol-
low-ups beyond six months.
Discussion: is study sheds light on the application of immune-check-
point therapy in routine gynecological oncology. Robust side eect man-
agement strategies, improved education, and vigilance during long-term
follow-up are essential for optimizing patient outcomes and therapeutic
success.
Conclusion: Further research should focus on rening management
strategies and educational resources for optimal patient care in gyneco-
logical oncology.
Disclosure Statement: e authors declare no conict of interest.
593
G8-geriatric screening tool indicates a higher revision rate
preoperatively in gynecologic oncology patients
Valerie Catherine Linz1; Marco Battista1; Emma Rosemarie Liebau1;
Marcus Schmidt1; Annette Hasenburg1; Katharina Gillen²
1Department of Gynecology and Obstetrics, University Medical Center of the
Johannes Gutenberg University Mainz, Mainz, Deutschland
2Abteilung Gynäkologie, Jung-Stilling-Krankenhaus, Diakonie Klinikum, Siegen,
Deutschland
Purpose: is prospective, single-center study investigates a preoperative
frailty screening for gynecologic oncology patients undergoing tumor
surgery.
Methods: All gynecologic oncology patients aged 60 years and older par-
ticipated in a standardized frailty assessment with the G8-geriatric screen-
ing tool before tumor surgery at the University Medical Center Mainz
from May 2020 till August 2023.
Results: 193 patients were screened preoperatively and 159 patients were
included, comprising patients with ovarian (n=51, 32.1%), endometrial
(n=57, 35.8%), cervical (n=7, 4.4%), vulvar (n=30, 18.9) and vaginal (n=3,
1.9%) cancer. 59 (37.1%) patients were classied as G8-frail (≤ 14 points)
according to the G8-geriatric screening tool and underwent a second
frailty assessment. Mean age was 70.0 (+/- 7.8) years. G8-frail patients
had numerically but not statistically signicantly higher deviation rates
of their guideline-recommended standard therapy for their respective
tumor entity (15.3% vs. 7%; p=0.108). Furthermore, the G8-frail patients
had more surgical revisions (16.9% vs. 5%; p=0.022) and seemed to have a
longer hospital stay (p=0.072) than the G8-non-frail cohort. During mean
follow-up of 10.2 (+/-9.9) months, more patients died in the G8-frail
cohort than in the G8-non-frail cohort (15.3 vs. 5.0%, p=0.041).
Discussion: To ensure a possible operationalization of frailty, a frailty
assessment was established in our gynecologic oncology department. Frail
patients need prehabilitation before surgery and in some cases an individ-
ualized surgical approach. However, elderly patients classied as not being
frail require standardized surgical therapy to not impair their oncologic
prognosis due to a less radical surgery.
Conclusion: e G8-screening tool is a simple and short test for older
gynecologic oncology patients that can be easily implemented in the clin-
ical routine and appears to be a good marker for surgical revisions in the
frail cohort.
Disclosure Statement: e authors declare no conict of interest.
599
Induction of prostate specic membrane antigen (PSMA)
on endothelial cells by incubation with tumor-conditioned
medium of dierent ovarian cancer cell lines
Sophia Persin; Markus Jäger; Felix Hertel; Ingolf Juhasz-Böss; Clara Unger
Klinik für Frauenheilkunde, Universitätsklinikum Freiburg, Freiburg,
Deutschland
Background: Due to the poor prognosis of ovarian cancer, there is a need
for new diagnostic and therapeutic approaches. PSMA was detected on
neovasculature of various malignant tumors.1 Its induction on endothelial
cells could be achieved by incubation with tumor-conditioned medium
(TCM) of various tumor cell lines.2ere is evidence that PSMA may
function as a pro-angiogenic factor and thus aect tumor development.
e aim of this work is to show PSMA induction on endothelial cells,
under incubation with TCM of dierent ovarian cancer cell lines and to
investigate the eect of hypoxia on PSMA expression.
Methods: Human Umbilical Vein Cells (HUVECs) are cultured in the
extracellular matrix Geltrex™ and incubated with TCM of ovarian cancer
cell lines (EFO-21, OAW-42, SK-OV-3). e colon cancer cell line HCT-15
serves as a positive control and the cell line HOSE-6 (ovarian epithelium)
as a negative control. PSMA expression will be determined by RT-qPCR.
Detection at the protein level will be performed by immunocytochemis-
try. For the experiments under hypoxia, a gas mixture with 3% O2 is used.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 95
Result: e results will be shown on site.
Discussion: e induction of PSMA on HUVECs by incubation with
TCM may provide clues to the role of PSMA in a regulatory pathway.
Ovarian cancer cells seem to secrete factors that induce PSMA expression
on endothelial cells, whereby PSMA may promote tumor development as
a pro-angiogenic factor.
Conclusion: If PSMA induction is shown on endothelial cells by incuba-
tion with TCM of ovarian cancer cell lines, PSMA may be a suitable target
in diagnosis and targeted tumor therapy of ovarian cancer.
Indication of source:
1 Chang SS, Gaudin PB et al. Five dierent anti-prostate-specic membrane
antigen (PSMA) antibodies conrm PSMA expression in tumor-associated
neovasculature. Cancer Res. 1999;59(13):3192–3198.
2 Nguyen DP, Liu H, et al. Induction of PSMA and Internalization of an
Anti- PSMA mAb in the Vascular Compartment. Mol Cancer Res.
2016;14(11):1045–1053.
Disclosure Statement: e authors declare no conict of interest.
724
N-acetylaspartylglutamate (NAAG) - synthetases I and II
inovarian cancer
Philipp Groß1; Markus Jäger1; Soe Schoenhals1; Felix Hertel1;
Claudia Nöthling1; Ingolf Juhasz-Böss1; Clara Unger1; Konrad Kurowski2;
Peter Bronsert2,3
1Klinik für Frauenheilkunde - Universitätsklinikum Freiburg, Freiburg im
Breisgau, Deutschland
2Uniklinik Freiburg - Institut für Klinische Pathologie, Freiburg im Breisgau,
Deutschland
3Core Facility für Histopathologie und Digitale Pathologie Freiburg,
Universitätsklinikum Freiburg, Freiburg im Breisgau, Deutschland
Background: N-acetylaspartylglutamate (NAAG), a prevalent neu-
rotransmitter in the brain, has been detected in ovarian cancer (1). A
proven positive correlation exists between NAAG levels in tumor/serum
and in vivo tumor growth (1). e role of NAAG in ovarian cancer
remains unclear. Our study aims to demonstrate hypoxia-induced expres-
sion of NAAG synthetase-encoding RIMKL A and B genes, followed
by NAAG level measurement. We also plan to immunohistochemically
detect RIMKL A and B in primary high-grade serous ovarian carcinoma
patients and correlate its expression with survival and clinical parameters.
Methods: We conducted cell experiments on ovarian cancer (COV-362,
EFO-27, OAW-42, SK-OV-3) and one epithelial cell line (HOSE) under
chemical hypoxia (CoCl2) for dened durations (3h, 6h, 12h, 24h). We
used qPCR, Western blots, immunocytology, and viability assays for eval-
uation. Mass spectrometry determined NAAG levels in cells and medium.
A tissue microarray (TMA) of 61 ovarian cancer patients’ samples was
immunohistochemically stained for RIMKL A and B using HaloAI so-
ware (Indicalabs, Albuquerque, USA).
Result: Hypoxia led to elevated RIMKL A expression across all cell lines,
conrmed at the protein level through Western blot analysis. Additional
ndings will be presented on site.
Discussion: Gene induction showed temporal variation between RNA
and protein levels, hinting at potential feedback mechanisms.NAAGs
conversion to glutamate presents a potential alternative energy pathway
for tumors. In this case, tumors with high NAAG concentrations may
have a growth advantage.
Conclusion: If there is a correlation between RIMKL A/RIMKL B expres-
sion and clinicopathological progression of the patients, the expression of
this, as well as the serum NAAG concentration if applicable, could serve
as a predictive marker.
Indication of source:
Nguyen et al.Uncovering the role of N-acetyl-aspartyl-glutamate as a glutamate
reservoir in cancer. Cell Rep.2019;27:491–501 e6. doi:10.1016/j.celrep.2019.03.
Disclosure Statement: e authors declare no conict of interest.
741
Characteristics, Treatment Patterns and Survival of FIGO Stage
IV Epithelial Ovarian Cancer – a Population Based Study
Dorothee Jakob2, Claudia Schmoor1; Raphael Reuten2; Marie Louise
Frevert2; Dominik Dannehl3; Silke Hermann4; Peter Jungmann2; Moritz
Breitbach2; Andreas Hartkopf3; Ingolf Juhasz-Boss2; Florin-Andrei Taran2
1Universitätsklinikum Freiburg, Klinik für Frauenheilkunde, Deutschland
2Universitätsklinikum Freiburg, Institut für Experimentelle und Klinische
Pharmakologie und Toxikologie, Deutschland
3Universitätsklinikum Tübingen, Klinik für Frauenheilkunde, Deutschland
4Universitätsklinikum Freiburg, Zentrum für Klinische Studien, Deutschland
Purpose: e aim of the study was a description of an unselected popu-
lation of patients with primary diagnosis of FIGO stage IV ovarian can-
cer (OC) regarding baseline patient and tumor characteristics, treatment
strategies and prognosis.
Methods: We utilized the Baden-Württemberg Cancer Registry to iden-
tify FIGO stage IV OC patients registered during a period of 8 years, data
of 1183 patients were analysed.
Results: 669 of the patients (56.6%) received any kind of surgery, 881
(68.6%) were treated with systemic therapy, and 523 (44.2%) received both
surgery and systemic treatment. 221 patients (18.7%) did not receive any
treatment. Median overall survival was 1.9 years. Especially the patients
>80 years had a low overall survival rate (hazard ratio of age >80 years vs.
≤50 years was 3.81, 95%-condence interval [2.76,5.27]. Regarding histo-
logical subtypes, survival was best for patients with HGSOC (p<0.0001).
e highest overall survival rate was observed for patients that underwent
surgery followed by systemic treatment with an unadjusted hazard ratio
vs. systemic treatment only of 0.67, 95%-condence interval [0.55,0.84].
Discussion: Our study shows that patients with FIGO IV OC benet
from surgical treatment which is reected in current treatment recom-
mendations. In contrast to available data, we could show that over 80%
of the patients received cancer-directed treatment for FIGO stage IV OC.
e strengths of this study include the analysis of a large dataset from the
Baden-Württemberg Cancer Registry, with over 1100 patients with FIGO
stage IV OC and the time span of 8 years. Limitations are the retrospective
nature of the study and missing data on possible confounders.
Conclusion: In this large cohort of patients with FIGO stage IV OC over
80% of the patients received cancer directed treatment. Age and high
grade serous histology were determining factors for survival. e highest
overall survival rate was observed for patients with FIGO stage IV OC that
underwent surgery followed by systemic treatment.
Disclosure Statement: e authors declare that there are conicts of interest.
econicts were submitted to the congress organizer KUKM GmbH and KUKM
can disclose them if needed.
747
Implementation and Update of guideline-derived quality
indicators for cervical cancer in gynecological cancer centers
certied by the German Cancer Society (DKG)
Frederik Stuebs1; Matthias Beckmann1; Tanja Fehm2; Christian
Dannecker3; Markus Follmann4; Thomas Langer4; Simone Wesselmann4
1Department of Gynecology and Obstetrics, Erlangen University Hospital,
Comprehensive Cancer Center Erlangen-European Metropolitan Area
of Nuremberg (CCC ER-EMN), Friedrich-Alexander-Universität Erlangen,
ErlangenGermany
2Department of Gynecology and Obstetrics, University Hospital of Düsseldorf,
Düsseldorf, Germany
3Department of Obstetrics and Gynecology, University Hospital Augsburg,
Augsburg, Germany
4German Cancer Society e.V., Berlin, Germany
Purpose: In 2008, the rst gynecological cancer centres (GCC) were
certied by the German Cancer Society (DKG). Guideline-based Quality
Indicators (QI) are a core element of the certication process. ese QI
are dened to assess the quality of care within the centres and can serve to
measure the implementation of guideline recommendation. is abstract
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts96
aims to give an overview of the developing and updating process of guide-
line based-QIs for women with cervical cancer and presents the QI results
from the certied GCC.
Methods: e QIs are based on strong recommendations and developed
in a multiple step review process and then implemented in the certica-
tion data sheet of the certied centres. e rst set of QIs created in 2014
was revised in the update process of the S3- Guideline in 2020. Results of
the four QI were quantitatively analyzed.
Results: In total, there are nine guideline based QI’s for cervical cancer.
Four QI’s are part of the certication process. In the treatment year 2020,
3.522 cases of cervical cancer were treated in 169 centers. e target values
for the four QI’s were met in at least 95% of the certied centers. In the
guideline update in 2020, a new QI was added to the set of QI’s “Complete
pathological report on conization ndings” and the QI “Exenteration
was removed, due to the low number of exenterations (n = 43) performed
in2020.
Discussion: Over the years, the number of GCC has grown, and the results
of the QI and thus the quality of care within the centres was improved.
e results of the QI are used in the certication system as well as in the
guideline updates for a continuous reection and further development of
the structures.
Conclusion: QI’s derived from strong recommendations of a guideline
are an important tool to make essential parts of patients care measurable.
With QI, it is possible to implement guideline content quickly and sus-
tainably in the centers and enable them to draw consequences in process
optimization and treating their patients in accordance with the guidelines.
Disclosure Statement: e authors declare no conict of interest.
795
The HER2-ultra low expression of high-grade serous ovarian
cancer and endometrial cancer
Clara Unger1; Peter Bronsert2; Ingolf Juhasz-Böss1; Konrad Kurowski2
1Uniklinik Freiburg - Klinik für Frauenheilkunde, Freiburg im Breisgau,
Deutschland
2Uniklinik Freiburg - Institut für Klinische Pathologie, Freiburg im Breisgau,
Deutschland
Background: e importance of HER2-targeted therapies is increasing -
based on the results of the DESTINYBreast05 study, HER2-low tumours
are treated with a HER2-therapy. e relevance of a very low HER2
expression as a target in metastatic breast carcinomas, the so-called HER2
ultra-low breast carcinoma (with a score between 0 and 1+), is currently
being investigated within the DESTINYBreast06 study. HER2 expression
has already been described in endometrial and ovarian cancer. Within the
PANDestiny02 trial, HER2 positive genital carcinomas have been treated
with promising results.
Based on this, patient collectives with an endometrial or an ovarian
carcinoma will be evaluated regarding the HER2 ultra-low expression.
e results will then be correlated with the clinical data.
Methods: TMAs from 123 endometrial carcinoma and 61 high-grade
serous ovarian carcinoma patients were examined. Primary tissue, as well
as lymph node or distant metastases were evaluated.
e samples were immunohistochemically stained with the Ventana
antibody anti-HER2/neu (4B5) and evaluated by two pathologically expe-
rienced physicians analogously to breast carcinoma. e scores ultra low
(IHC: >0<1+), low (IHC: 1+, 2+) and high (IHC: 3+) were assigned.
Results: A Her2 ultra low expression was found in 22.6% of the ovarian
cancer samples and in 49.6% of the endometrial cancer samples. Further
results will be shown on site.
Discussion: e interim results of the PANDestiny02 trial presented on
the ASCO 2023 show that 67 patients didn’t show a IHC 2+ or 3+ expres-
sion. So HER2-low tumours were treated (1).
Is a HER2 ultra low expression sucient for a HER2 therapy indication?
Conclusions: HER2 ultra-low expression is present in the tumour entities
investigated. e clinical benet of this information has to be proven.
Indication of source:
1 Ecacy and safety of trastuzumab deruxtecan (T-DXd) in patients (pts) with
HER2-expressing solid tumors: DESTINY-PanTumor02 (DP-02) interim
results.
Funda M, Jung-Yun L et al.
J of Clin Onc202341:17.
Disclosure Statement: e authors declare no conict of interest.
944
Prostate specic membrane Antigen (PSMA) expression in
Endometrial carcinoma and its metastases
Valentine Guyon1; Konrad Kurowski2; Peter Bronsert2; Ingolf Juhasz-Böss1;
Clara Unger1
1Uniklinik Freiburg - Klinik für Frauenheilkunde, Freiburg im Breisgau,
Deutschland
2Uniklinik Freiburg - Institut für Klinische Pathologie, Freiburg im Breisgau,
Deutschland
Background: Advanced endometrial carcinoma is a therapeutic chal-
lenge. Endometrial carcinoma is the 5th most common cancer in women
in Germany. PSMA was detected in dierent tumor entities. In prostate
cancer, PSMA is a proven predictive and diagnostic marker. PSMA has
previously been detected in endometrial carcinoma, but the data on its
expression there is inconsistent. e aim of this study is to demonstrate
the expression of PSMA in tumor cells and tumor neovasculature, in pri-
mary tumors and in metastases of endometrial carcinoma patients and to
correlate them with clinicopathological parameters.
Methods: Tissue samples from 123 patients of the CCCF (Comprehensive
Cancer Center Freiburg) who underwent primary surgery for endome-
trial carcinoma were examined. A tissue microarray (TMA) was created
per patient with up to 3 samples from the central tumor tissue, 2 samples
from the tumor periphery and up to 3 samples in case of metastases. is
was followed by immunohistochemical staining of the TMA with CD31
(clone JC70A from Dako, Carpinteria, USA) as an endothelial cell marker
to determine the general vessel density, and a staining with a PSMA anti-
body (clone 3E6 from Dako). en digital-assisted analysis of the stained
TMA sections using the image analysis program QuPath® (University of
Edinburgh, Scotland) was performed.
Result: PSMA is expressed in both, tumor cells and tumor vessels. Tumor
cells were PSMA positive in 58.5% of primary tumor samples and ≥50%
of vessels in 76.4% of cases. A signicant association was demonstrated
between PSMA expression in vessels and lymphatic vessel invasion
(p=0.007) and maximum tumor size (p=0.007).
Discussion: Gordon at al. found PSMA expression in healthy prolifera-
tive endometrial cells. In the evaluated patient collective, this could not
be conrmed. Further studies are needed to allow a signicant statement
about the expression of PSMA in proliferative endometrial cells.
Conclusion: PSMA may allow for new targeted therapy alternatives for
endometrial carcinoma.
Disclosure Statement: e authors declare no conict of interest.
949
Targeting PLK1 and PLK3 sensitizes cervical cancer
to cisplatin-based chemoradiotherapy
Khayal Gasimli; Monika Raab; Nurlana Gasimli; Morva Tahmasbi Rad;
Sven Becker; Klaus Strebhardt; Mourad Sanhaji
Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
Background: Resistance to cisplatin is a potential complication, signi-
cantly undermining the drug’s eectiveness in managing advanced or
recurrent cervical cancer (CC). Our investigation explored the molecu-
lar mechanisms governing the PLK1-PLK3 heterodimerization and its
clinical signicance in enhancing the responsiveness of cervical cancer
patients to cisplatin-based chemoradiotherapy.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 97
Methods: To explore the mechanistic details of PLK1-PLK3 heterodi-
merization in vitro and cells, we: 1) mapped the dimerization domains
in vitro using dierent fusion constructs containing either the kinase
domain, the polo box domains, or the full length of the two proteins. e
heterodimerization was monitored using co-immunoprecipitation (co-IP)
and pulldown assays in vitro. 2) We established a CC cell line expressing
an endogenously tagged version of PLK3, HeLa-V5-PLK3, using CRISPR/
Cas tagging system.
Result: In this study, we identied and functionally characterized the
heterodimer PLK1-PLK3. We found that both the kinase and polo box
domains of PLK1 and PLK3 can dimerize in vitro and cells. We discov-
ered that when DNA damage occurs, PLK3 heterodimerizes with PLK1,
causing a reduction in PLK1 activity, which is necessary to arrest the cell
cycle and allow cells to repair the DNA damage. By interfering with PLK1-
PLK3 heterodimerization, cells could bypass the checkpoint, resulting in
increased chromosomal instability as cells enter mitosis with unrepaired
damage. Furthermore, we found that patient-derived cervical cancer cells
lacking PLK3 and treated with the PLK1 inhibitor BI6727 show a high
sensitivity to cisplatin-based standard therapy.
Conclusion: e targeting the PLK1-PLK3 heterodimer could represent a
valuable therapeutic strategy for resensitizing cisplatin chemoradiothera-
py-resistant CC. Consequently, new inhibitors targeting the PLK1-PLK3
heterodimer-monomer switch represent a highly attractive new treatment
opportunity that will be anticipated in clinical trials.
Disclosure Statement: e authors declare no conict of interest.
958
Analysis of HPV16 or HPV18 DNA in peritoneal washings and
serum as molecular marker for cervical cancer patients
Katharina Kuhnigk; Angela Kather; Davit Bokhua; Ingo B. Runnebaum;
Norman Haefner
Jena University Hospital, Dept. of Gynecology, Jena, Deutschland
Background: e presence or the dynamic change of HPV fragments in
cell-free DNA (cfDNA) from blood of cervical cancer (CxCa) patients
may be used as molecular biomarker to inform about tumor expansion
and disease prognosis. However, the signicance of the HPV DNA in the
cellular or cell-free fraction of peritoneal washings (PW) is unclear.
Methods: Genomic and cfDNA from PW (n=45) and cfDNA from serum
(n=33) was isolated by commercial kits. Highly sensitive qPCR assays tar-
geting HPV16 or 18 were established and validated by articial samples.
Absolute and relative quantication of qPCR results were realized by com-
parison against plasmid dilution series or beta-actin reference sequences.
HPV results were compared to clinical parameters and the prognostic
value was analyzed by Kaplan-Meier plots and Cox regression.
Result: e level of HPV DNA fragments in the cfDNA of PW was more
strongly associated with clinical parameters (tumor expansion) or prog-
nosis (PFS, OS) than the amount of HPV in the cellular fraction of PW.
Both the level of HPV in cfDNA of PW or serum was signicantly dier-
ent in patients stratied by pT (pT1/>pT1), pN (pN0/pN1), cM (cM0/
cM1), FIGO (<IIA/≥IIA) but not by dierentiation status (G). e qual-
itative detection of HPV in cfDNA of PW or serum was not associated
with reduced survival. However, determined cut-o values could dier-
entiate patients with signicantly dierent PFS/OS (LogRank p<0.01; HR
3.5 – 6.7).
Discussion: e quantication of HPV DNA in cfDNA of both PW and
serum can inform about the expansion of the tumor and has a prognostic
value. ese data need to be conrmed in larger sample sets enabling mul-
tivariate analyses to fully evaluate this biomarker. Analyses of the dynamic
changes of HPV level in serum cfDNA are ongoing.
Conclusion: HPV DNA quantication in cfDNA may have the potential
to inform about the tumor expansion and to enable treatment decisions
pre-operatively.
Disclosure Statement: e authors declare no conict of interest.
959
Nectin-4 expression in vulvar squamous cell carcinoma - a
possible target for the treatment approach with antibody
drug conjugates (ADC)
Lars-Christian Horn1; Anne Kathrin Höhn1; Blake Gilks2; Naveena Singh2;
Bahriye Aktas3; Nadja Dornhöfer3; Ruth Hiller1
1Division of Gynecologic Pathology, University of Leipzig, Leipzig, Deutschland
2Vancouver General Hospital and the University of British Columbia, Canada,
Vancouver, Kanada
3Universitätsklinikum Leipzig AöR, Leipzig, Deutschland
Background: Nectin-4 (syn: poliovirus receptor-related protein 4;
PVRL4) served as a tumor associated inducer in various malignant
tumors including urothelial, breast, lung, colorectal, pancreatic, ovarian
cancers. Over-expression of Nectin-4 is associated with various aspects
of tumor progression like proliferation, angiogenesis, epithelial to mesen-
chymal transition, metastasis, DNA repair, tumor relapse, poor prognosis
in several types of cancer.It is a component of antibody-drug conjugate
(ADC) enfortumab vedotin (EV). ere are no data about the expression
proles of Nectin-4 in VSCC.
Methods: 55 VSCC were immunohistochemically analysed for Nectin-4
expression using a H-score (staining intensity (SI) x percentage of positive
stained tumor cells) Overall staining scores were compared to the 3-tiered
molecular subtyping of vulval carcinoma, dening p16+ve/p53wt, p16-ve/
p53mut and p16-ve/p53wt VCX. Staining evaluation of Nectin-4 was blinded
to the molecular subtype.
Results: Virtually, all VSCC represented positive immunostaining for
Nectin-4, with mean H-score of 4.8 (range 2-9). ere were no dierences
of Nectin-4 expression within the dierent molecular subtypes of VSCC:
mean H-score 5.2 (range 2-9) for p16+ve/p53wt, 4.8 (range 2-9) for p16-ve/
p53mut and 2.5 (range 2-3) for p16-ve/p53wt VSCC (p=0.27).
Conclusion: e ADC enfortumab vedotin (EV) comprised nectin-4
conjugated via a cleavable linker to the microtubule inhibitor MMAE and
was approved for the treatment of urothelial cancer. Virtually all exam-
ined VSCC showed at least weak staining for Nectin-4 within the tumor
cells. So, Nectin-4 may represent a potential target for ADC in vulvar can-
cer. ere are no dierences of Nectin-4 expression within the dierent
molecular subtypes of VCX.
Disclosure Statement: e authors declare no conict of interest.
960
Trop-2 expression in vulvar squamous cell carcinoma
(VSCC) - a possible target for the treatment approach with
antibody drug conjugates (ADC)
Lars-Christian Horn1; Anne-Kathrin Höhn1; Barhyhie Aktas2;
Nadja Dornhöfer2; Blake Gilks3; Naveena Singh3; Lien Hoang3; Ruth Hiller1
1Division of Gynecologic Pathology, University of Leipzig, Leipzig, Deutschland
2Universitätsklinikum Leipzig AöR, Leipzig, Deutschland
3Vancouver General Hospital and the University of British Columbia, Canada,
Vancouver, Kanada
Background: e Trophoblast Cell Surface Antigen 2 (TROP-2) is asso-
ciated with invasiveness and tumor progression in several malignancies.
Strong TROP-2-expression is associated with poor prognosis in cervical
carcinoma. Recently, TROP-2 was identied as a target protein for treat-
ment of solid tumors using antibody-drug conjugates (ADC). ere are
no details about the expression proles of TROP-2 in vulval cancer (VCX).
Methods: 55 cases of squamous cell carcinomas of the vulva were immu-
nohistochemically analysed for TROP-2 expressio using a H-score (stain-
ing intensity (SI) x percentage of positive stained tumor cells). was score
das negative (0), weak (1), moderate (2) and strong (3). Overall staining
scores were compared to the molecular subtypes of vulval carcinoma,
dening p16+ve/p53wt, p16-ve/p53mut and p16-ve/p53wt VCX. Staining eval-
uation of TROP-2 was blinded to the molecular subtype.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts98
Results:
All cases were positive for TROP-2 (7 cases +, 31 cases ++ and 17 cases
+++)
• p16+ve/p53wt 16 cases mean value h-score 7,25
• p16-ve/p53mut 31 cases mean value h-score 6,44
• p16-ve/p53wt 2 cases mean value h-score 4
Conclusion: It has been shown that the antibody drug conjugate (ADC)
topoisomerase-1-inhibitor irinotecan, coupled via a linker to a humanised
IgG-1ntibody hRS7 binding to TROP-2 (i.e. sacitumzumab) represents
an eective treatment approach to several carcinoma types. Virtually all
examined VCX showed at least weak staining for TROP-2 within the
tumor cells. So, TROP-2 may represent a potential target for ADC in
vulval cancer. ere are no dierences of TROP-2 expression within the
dierent molecular subtypes of VCX.
Disclosure Statement: e authors declare no conict of interest.
961
3-tiered Molecular Classication of Squamous Cell Vulvar
Cancer: Matched-pair analysis: pre-surgical biopsy versus
radical vulvectomy from the same patient
Lars-Christian Horn1; Mirham Forberger1; Ruth Hiller1; Blake Gilks2;
Naveena Singh2; Lien Hoang2; Bahriye Aktas3; Nadja Dornhöfer3;
Anne Kathrin Höhn1
1Division of Gynecologic Pathology, University of Leipzig, Leipzig, Deutschland
2Vancouver General Hospital and the University of British Columbia, Canada,
Vancouver, Kanada
3Universitätsklinikum Leipzig AöR, Leipzig, Deutschland
Background: Classication of vulvar carcinoma (VCX) into one of
the three molecular subtypes has signicant prognostic and therapeu-
tic impact. An HPV-associated lesion that is p16 positive and p53 wild
type represents improved prognosis compared to other subtypes. A third
(minor) subtype is characterized by normal staining for both markers. It
has been shown that patients with p53-aberrant tumors may benet from
more radical surgical approach. Contrary, HPV-high risk associated VCA
represent better response to chemoradiation.
e aim of this study was to determine the concordance of molecular sub-
typing on diagnostic biopsy compared to the surgical resection specimen.
Methods: 56 matched pairs of VCA diagnostic biopsies (Bx) and its
surgical resection specimens (vulvectomies) were immunohistochemi-
cally evaluated for the immunoexpression of p16 and p53. e molecu-
lar results of the resection specimens were used as “gold standard. e
examination of the Bx were blinded to the ndings within the resection
specimen.
Results: Matched pair analysis represented a high agreement for molecu-
lar subtyping of VCX comparing diagnostic Bx and the surgical resection
specimen: 93.7% (16/17 cases) for the p16+/p53wt cases; 94.4% (34/36) for
p16-/p53mut. Within the p16- /p53wt VCX there was a lower concordance
(50%; 2/4 cases).
Conclusion: ere is a high concordance rate (~94%) between diagnostic
Bx and surgical resection specimen for the two major types within the
molecular classication of VCX using immunoexpression of p53 (as a sur-
rogate marker for TP53-alterations) and p16 (as a surrogate marker for
HPV high-risk infection).
ese results may represent a valuable nding within the clinical setting
for treatment decisions. By accurate subtyping of the VCX before curative
treatment, the prognostically best treatment approach can be chosen for
the patients.
So, molecular subtyping of VCX within diagnostic biopsies represents a
robust tool to tailor the treatment approach of patients with VCX.
Disclosure Statement: e authors declare no conict of interest.
Head and Neck Cancer
160
Glycoprotein A repetitions predominant (GARP) in oral
cancer - implications for tumor progression
and patient outcomes
Sebastian Blatt1; Emily Trzeciak2; Niklas Zimmer2; Lorenz Schütz1;
Maximilian Krüger1; Nadine Wiesmann-Imilowski1; Peer Kämmerer1;
Daniel Thiem1; Andrea Tüttenberg2; Bilal Al-Nawas1
1Klinik für MKG Chirurgie, Universitätsmedizin Mainz, Mainz, Deutschland
2Hautklinik, Universitätsmedizin Mainz, Mainz, Deutschland
Background: e survival rate of oral cancer remains poor but the under-
lying mechanisms that determine disease progression are not yet fully
understood. Glycoprotein A repetitions predominant (GARP) is overex-
pressed in the suppressive TME and aids in the inhibition of anti-tumor
immune responses. is study aimed to examine the distinctive role of
GARP in oral(pharyngeal) carcinogenesis and to evaluate its potential as
a prognostic biomarker.
Methods: GARP expression in a OPSCC cell line (FaDu) was evaluated
by ow cytometry and western blot. Stably transfected GARP+ cell lines
were developed. Migration, proliferation, suppression, and tumor sphe-
roid growth assay were performed. Drug resistance to cisplatin and radi-
ation was tested. Retroactive analyses of GARP mRNA levels in tumor
tissue were performed. GARP expression in tumor tissue was analyzed via
immunohistochemistry. sGARP levels were quantied in patient serum.
Result: High levels of GARP were shown in OSCC tumor tissue and the
OPSCC cell line, FaDu. Stably transfected GARP+ FaDu cells were tested
for enhanced suppressive capacity. Retroactive analysis of GARP mRNA
levels did not correlate with patient overall survival. GARP protein lev-
els were linked to tumor recurrence and overall survival. Cancer patients
showed higher levels of sGARP than healthy donors, but sGARP levels did
not correlate with TNM status.
Discussion: GARP plays a critical role in the production and release of
active TGF-β. is way, GARP orchestrates tumor immunosuppressive
strategies, leading to an inhibitory TME and thereby supporting tumor
progression. e presented data conrms a vital role of GARP in oral
carcinogenesis.
Conclusion: Our results indicate for the rst time that GARP plays a sig-
nicant role in oral carcinogenesis.
Disclosure Statement: e authors declare no conict of interest.
268
The impact of demographic change on the survival of head
and neck cancer patients in Germany at national
and county level
Julius Vahl1; Gabriele Nagel2; Ayla Grages1; Matthias Brand1;
Adrian von Witzleben1; Michael Sonntag1; Marie-Nicole Theodoraki1,3;
Jens Greve1; Tsima Aboukors1; Michael Denkinger4; Dhayana Dallmeier4;
Christian Idel5; Stephan Stilgenbauer6; Thomas Homann1; Simon Laban1
1Klinik für Hals-, Nasen- und Ohrenheilkunde am Universitätsklinikum Ulm, Ulm,
Deutschland
2Institut für Epidemiologie und Medizinische Biometrie Ulm, Ulm, Deutschland
3Klinik für Hals-, Nasen- und Ohrenheilkunde am Klinikum rechts der Isar der
Technischen Universität München, München, Deutschland
4Agaplesion Bethesda Klinik Ulm, Ulm, Deutschland
5Klinik für Hals-, Nasen- und Ohrenheilkunde am Universitätsklinikum
Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
6Universitätsklinikum Ulm Klinik für Innere Medizin III, Ulm, Deutschland
Background: e German population is aging. In addition, there are
shiing population structures in geographic terms between urban and
rural areas as well as between East and West. is demographic change
could have an impact on the survival of head and neck cancer patients
(HNCP).
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 99
Methods: We performed a nationwide analysis on the incidence and the
association of epidemiological indicators with survival. Between 2002 and
2017 data of 212920 HNCP from the Center for Cancer Registry Data and
the Federal Statistical Oce were collected in this context.
Result: e prevalence of HNCP in patients older than 70 years rose from
20.6% in 2002 to 34.4% in 2017, especially in urban areas. Furthermore,
we observed a faster increase in mean age among our patients compared
to the normal population (slope coecient: 0.29 vs. 0.20; p < 0.001), again
notably in urban areas. In East Germany median overall survival was
lower than in West Germany: 47 vs. 60 months (p < 0.0001). In addition,
median survival of HNCP in rural areas was lower than in urban areas in
East but not in West Germany (42 vs. 54 months; p < 0.0001). is dis-
parity was associated with a higher proportion of men in East Germany
(men/women: 4.4 vs. 3.1; p < 0.0001), with a lower median age (61 vs. 63
years; p < 0.001) and with higher travel distances to medical centers (69.4
vs. 30.6 km; p < 0.0001).
Discussion: e current demographic changes are associated with a
higher prevalence of HNCP in older patients. Regardless of reunication,
a HNCP related survival disadvantage for patients in East Germany, par-
ticularly in rural areas, still becomes apparent.
Conclusion: Place of residence contributes to survival outcome of HNCP
in Germany. Access to specialized care and socioeconomic factors could
be improved, especially in East Germany.
Disclosure Statement: e authors declare no project-related conict of interest.
306
Information is the Key: First Glimpse into the Prospective
NAVIGATORR Trial
Sebastian Regnery1; Lukas Bauer1; Reinald Kühle2; Jennifer Fuchs2;
Julius Moratin2; Florian Stritzke1; Philipp Schröter1; Katharina Weusthof1;
Maximilian Deng1; Tanja Eichkorn1; Sebastian Adeberg3; Jürgen
Homann2; Jürgen Peter Debus1; Christian Freudlsperger2; Thomas Held1
1Universitätsklinikum Heidelberg, Abteilung für RadioOnkologie und
Strahlentherapie, Heidelberg, Deutschland
2Universitätsklinikum Heidelberg, Klinik und Poliklinik für Mund-, Kiefer- und
Gesichtschirurgie, Heidelberg, Deutschland
3Universitätsklinikum Gießen und Marburg (UKGM) | Standort Marburg,
Abteilung für Strahlentherapie, Marburg, Deutschland
Background: Head-and-neck cancers (HNC) are frequently detected in
locally-advanced stages. Despite surgery and postoperative radiotherapy
(PORT), many patients experience tumor progression. Information loss
between disciplines seems an Achilles heel of current approaches. Hence,
we investigate how an interdisciplinary workow based on modern imag-
ing with intraoperative navigation impacts treatment outcomes.
Methods: NAVIGATORR is a prospective clinical trial that enrolls 60
patients with locally-advanced HNC of the skull base. Patients undergo
tumor resection with an intraoperative optical navigation system
(Brainlab, Munich, Germany). Resection is planned based on state-of-the
art CT and MRI by an interdisciplinary team (surgeons, radiologists, radi-
ation oncologists). Surgeons take standardized resection margin biopsies
(MARBs). MARBs are localized on the imaging, and pathology results are
annotated. en, the radiation oncologists import the intraoperative data
into their radiation planning soware to individualize PORT.
Result: So far, six patients underwent navigation-based tumor resection
and four patients received PORT. On average, 8.7 MARBs were taken
(range: 6 - 14), and all were successfully annotated and transferred to the
radiation planning soware. e orientation of positive margins in the
main specimen and MARBs correlated in ve cases. One patient showed
clear margins in the main specimen but one positive MARB, which led
to re-resection (nally R0). e high dose planning target volumes (66
– 70 Gy) acc. to DAHANCA guidelines correctly encompassed positive
MARBs in all cases.
Discussion: Our early experience supports the feasibility of our inter-
disciplinary workow and demonstrates the potential benets of a data
round-trip. Still, NAVIGATORR is a work in progress. We are looking
forward to more extensive and mature data.
Conclusion: Combination of modern imaging, intraoperative naviga-
tion and interdisciplinary teamwork can enhance oncological safe tumor
resection and PORT target volumes.
Disclosure Statement: e authors declare the following: RK and CF previously
acted as advisors of Brainlab, Germany.
325
HPV-16 positive HNSCC cells exhibit a pronounced
oxygen dependence and reduced glycolytic capacity
forenergyproduction
Norio Kasahara1; Jennifer Stephania San Lucas Zambrano2;
Hytham Al Rabadi1; Andreas Ne3; Boris Alexander Stuck2; Ulrike Theiß4;
Michael Bette5; Wolfgang Meißner6; Robert Mandic2
1Klinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Hals-Chirurgie,
Universitätsklinikum Gießen und Marburg GmbH, Philipps-Universität
Marburg, Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie,
Universitätsklinikum Gießen und Marburg GmbH, Philipps-Universität Marburg,
Marburg, Deutschland
2Klinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Hals-Chirurgie,
Universitätsklinikum Gießen und Marburg GmbH, Philipps-Universität Marburg,
Marburg, Deutschland
3Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie,
Universitätsklinikum Gießen und Marburg GmbH, Philipps-Universität Marburg,
Marburg, Deutschland
4Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Gießen
und Marburg GmbH, Philipps-Universität Marburg, Marburg, Deutschland
5Institut für Anatomie und Zellbiologie, Philipps-Universität Marburg, Marburg,
Deutschland
6Institut für Humangenetik, Philipps-Universität Marburg, Marburg,
Deutschland
Background: e most important risk factors for the development of
head and neck squamous cell carcinomas (HNSCC) are tobacco and
alcohol consumption as well as infection with human papilloma viruses
(HPV). It has been known for many years that, compared with normal
cells, cancer cells, even in the presence of oxygen, increasingly use gly-
colysis for energy production, which is known as the Warburg eect or
aerobe glycolysis. In our study, we looked into the metabolic response of
HPVpos and HPVneg HNSCC cell lines aiming to uncover weak points for
therapeutic targeting.
Methods: Six HNSCC cell lines, 3 HPVneg and 3 HPVpos, were investigated
regarding their metabolic response by measuring the oxygen consump-
tion rate (OCR) and the extracellular acidication rate (ECAR) using the
Seahorse XFe96 Extracellular Flux Analyzer.
Results: HPVpos HNSCC cells compared with HPVneg HNSCC cells exhib-
ited signicantly higher values for i) ATP production by oxidative phos-
phorylation (OXPHOS), ii) basal respiration and iii) maximal respiratory
capacity. In HPVpos HNSCC cells, ATP production was signicantly more
derived from OXPHOS and signicantly less from glycolysis (GLYCO)
compared with HPVneg HNSCC.
Discussion: Inhibiting the glycolytic pathway could help radiosensitizing
not only HPVpos but in particular HPVneg HNSCC. is approach was also
reported by Fleming and colleagues, who used an inhibitor of the mono-
carboxylic acid transporter-1 in their study (Fleming et al. Br J Cancer.
2019 Feb;120(3):356-367).
Conclusions: e observations made in this study could explain clini-
cal observations in which patients with HPV-positive HNSCC typically
present with cervical lymph node metastases that are centrally necrotic,
since HPV-positive HNSCC in central hypoxic areas of the tumor possibly
can only poorly maintain energy production via glycolysis. Current work
of our group is investigating the inuence of photon- and particle based
therapies, in the presence or absence of metabolic inhibitors, on the radio-
sensitivity of HNSCC cells.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts100
366
Increasing outreach and awareness of head and neck cancer
by performing an o-site activity diary accompanying a
regional activity program (“UTA – Unterwegs trotz alledem”)
Sabine Felser1; Gunthard Kissinger2; Ute Kalinowski3; Ernst Klar4;
Christian Junghanß1; Sabina Ulbricht5
1Universitätsmedizin Rostock, Klinik III - Hämatologie, Onkologie,
Palliativmedizin, Rostock, Deutschland
2Selbsthilfenetzwerk Kopf-Hals-M.U.N.D.-Krebs e. V., Bonn, Deutschland
3Rostocker Selbsthilfegruppe für Tumor im Mund, Kiefer, Gesicht und Hals.,
Rostock, Deutschland
4Krebsgesellschaft Mecklenburg-Vorpommern e. V., Rostock, Deutschland
5Universitätsmedizin Greifswald, Institut für Community Medicine, Abt.
Präventionsforschung und Sozialmedizin, Greifswald, Deutschland
Background: “UTA - Unterwegs trotz alledem” was an information
and activity program, organized by the self-help network Kopf-Hals-
M.U.N.D.-Krebs e. V. It was piloted in Mecklenburg-Vorpommern (MV)
in June 2023. e aim was to increase the awareness of the general pop-
ulation with regard to causes and consequences of head and neck cancer
(HNC). e information campaign throughout the month was accompa-
nied by several local physical activities. ese were organized in dierent
areas of MV to promote joint activities for adults with and without can-
cer. To gain insights into the outreach of UTA, an o-site activity diary
(osAd) was developed and sent out on request. e outreach of UTA will
be described by using data from those who have returned osAd.
Methods: e osAd was designed for recording daily physical activities
during the month of action. e introduction section included questions
about sex, age, educational level (≤ 10 or > 10 years), postal zip code, rea-
sons for participation, and how they became aware of UTA. Participants
were asked to return the osAd in July 2023.
Result: In total, 102 osAd were sent out prior to the start of UTA and
54 were returned. is sample consists of individuals from nine federal
German states and Austria (75% woman, 63 ± 9 year, 70% > 10 years
of schooling). A proportion of 74% (n = 39) was suering from cancer,
mostly HNC (n = 28) Reasons for participation were e. g. “to support
research” (n = 12), “curiosity/overview of ones activities/tness” (n = 12),
or “as a stimulus to become more physically active” (n = 5). A proportion
of 63% became aware of UTA through self-help groups, 6% through social
media, and 4% through physicians.
Discussion: e osAd, as add-on to a local physical activity program,
seems to be benecial to reach individuals from other regions for partic-
ipation too. Self-help groups are important players in the promotion of a
program like UTA - even to non-HNC suerers.
Conclusion: In order to increase the reach, campaigns such as UTA
should be promoted earlier using more diverse communication channels.
Disclosure Statement: e authors declare no conict of interest.
411
Targeted therapy in salivary gland cancer: Prevalence of
actionable molecular alterations in a German tertiary referral
center patient cohort
Maximilian Linxweiler1; Sandrina Körner1; Felix Leon Braun1;
Moritz Knebel1; Lukas Alexander Brust1; Silke Wemmert1;
Mathias Wagner2; Bernhard Schick1; Jan Philipp Kühn1
1Saarland University Medical Center, Department of Otorhinolaryngology, Head
and Neck Surgery, Homburg/Saar, Deutschland
2Saarland University Medical Center, Department of General and Surgical
Pathology, Homburg/Saar, Deutschland
Background: Salivary gland carcinomas (SGC) are a heterogeneous group
of malignancies, with 24 subtypes dened by the WHO. e standard of
therapy is surgical resection, with adjuvant (chemo)radiotherapy in most
cases. However, disease recurrence or metastasis is common and no active
systemic therapies are currently available for RM-SGC resulting in a
5-year survival rate of only 20%.
Methods: 55 SGC patients with 8 dierent histological tumor subtypes
were included in this study. FFPE tissue samples were used for immu-
nohistochemistry targeting HER2/neu, androgen receptor (AR), PD-L1,
EGFR, panTRK, and TROP2. Immunoreactive scores (IRS) were assessed
by four independent examiners and correlated with clinical and histo-
pathological data.
Result: e overall prevalence of druggable molecular alterations dened
as IRS value ≥9 in at least one of the analyzed targets was 54,4%% with
the highest percentage in adenocarcinomas (87,5%) and lowest percent-
age in acinic cell carcinomas (10%). EGFR overexpression proved to be
the most common alteration (32,7% of cases) followed by overexpression
of TROP2 (27,3%), AR (19,9%), HER2/neu (5,5%), PD-L1 (1,8%), and
panTRK (1,8%).
Discussion: Our data indicate that targeted therapy using e.g. trastu-
zumab deruxtecan, bicalutamide, pembrolizumab, cetuximab, entrectinib
or sacituzumab govitecan might be a promising option for a relevant sub-
set of SGC patients. However, evidence from clinical studies regarding
response rates to these therapies remains sparse, which underlines the
need of multicenter clinical trials.
Conclusion: While response to systemic therapies in RM-SGC are clearly
limited molecular testing of the abovementioned targets can oer poten-
tial therapeutic options especially in RM-SGC cases not suitable for sal-
vage surgery.
Disclosure Statement: e authors declare no conict of interest.
424
Feasibility of an individual home training program for head
and neck cancer patients – results of the multicenter OSHO
#94 study
Sabine Felser1; Christian Junghanß1; Julia Rogahn1; Lars Arne Bonke1;
Daniel Fabian Strüder2; Jana Stolle3; Susann Schulze3; Markus Blaurock4;
Michael Schröder5; Sabina Ulbricht6; Christina Große-Thie1
1Rostock University Medical Center, Department of Medicine Clinic III,
Hematology, Oncology, Palliative Medicine, Rostock, Deutschland
2Rostock University Medical Center, Department of Otorhinolaryngology, Head
and Neck Surgery, Rostock, Deutschland
3University Hospital Halle, Department of Hematology and Oncology, Halle
(Saale), Deutschland
4University Medicine Greifswald, Department of Otorhinolaryngology, Head
and Neck Surgery, Greifswald, Deutschland
5University Medicine Greifswald, Department of Trauma, Reconstructive Surgery
and Rehabilitation Medicine, Greifswald, Deutschland
6University Medicine Greifswald, Institute for Community Medicine, Department
of Social Medicine and Prevention, Greifswald, Deutschland
Background: Physical activity may be a key factor in rehabilitation of
patients with head and neck cancer (pwHNC). e East German Study
Group for Hematology and Oncology (OSHO) is conducting a study to
evaluate the eects of a 12-week home-based, unsupervised, individual-
ized training program on quality of life (QoL, primary endpoint; OSHO
#94)1. Here, we present the feasibility results.
Methods: A multicenter, single-arm, prospective, longitudinal study
is conducted by the OSHO (DRKS00023883). Demographic and clin-
ical data are collected. Adherence to the training (e. g., frequency,
duration) as well as adverse events in terms of this are documented
by patients in a training diary and queried weekly by a therapist. The
program consists of an individualized training (selected exercises for
mobilization, coordination, strengthening, stretching) of three units
per week á 15-30 min and should be supplemented by at least 2 units
of endurance training á 30 min. We verified the hypothesis that the
proportion of pwHNC who dropped-out of the training program is
lower than 30%. QoL is assessed using EORTC-QLQ-C30, before and
after the training program.
Result: During 01/21 to 02/23, a number of 25 pwHNC (52% male, 66 ±
13 years, 92% complete remission) were included. Due to surgery or sus-
pected relapse three patients (12%) dropped out. On average, those who
completed the training program exercised 7 ± 3 times per week. ree
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 101
adverse events (AE; pain) were reported. QoL was higher aer the train-
ing program before the start (64 ± 16 vs. 72 ± 14, p = 0.042).
Discussion: Home-based training in pwHNC seems to be feasible. e
program was completed by 88% and the reporting of AEs were low. e
majority of pwHNC performed more training sessions as required by
protocol.
Conclusion: e feasibility of the study protocol was conrmed. Based on
these ndings the study will proceed recruiting.
Indication of source: (Optional, bitte löschen Sie diesen Absatz, wenn Sie keine
Quellenangaben haben):
1 Felser S et al., ONCOLOGY RESEARCH AND TREATMENT 2020; 43
(SUPPL 4): 134.
Disclosure Statement: e authors declare no conict of interest.
436
Quality of outcome in oral cancer patients - First results of
a perioperative evaluation of patient-specic inuencing
factors with special regard to mental and physical strength
Juliane Kröplin1; Jil-Charlot Reppenhagen1; Anke Hirsemann2; Jan Liese1;
Bernhard Frerich1
1Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Rostock,
Deutschland
2Onkologisches Zentrum, Rostock, Deutschland
Background: e aim of the present study is the perioperative analysis
of patient-specic factors inuencing the quality of outcome in head and
neck tumour surgery under university centre conditions.
Methods: Patients with oral squamosa cell carcinomas and indication for
surgical resection were included. General and disease-related data as well
as patient-specic resilience (RS-11 questionnaire) were collected. e
general quality of life was analysed in terms of importance and satisfaction
using the 9 items family/friends, sports activities, participation in culture,
professional perspectives, sexuality, enjoyable food, external appearance,
social recognition and independence on a Likert scale. e data collection
took place pre- and postoperatively during the inpatient stay.
Result: N=17 patients with squamous cell carcinoma of the oral cavity
were analysed (male: n=15, female n=3). e rate of R0 resections was
100%. N=7 of all patients was tracheotomised postop and n=4 patients
at the time of discharge. N=0 patients conrmed psycho(onco)logical
support preop (postop: n=12). Sports activities/physiotherapy was pro-
vided to n=0 patients preop (postop: n=12). e mean postop pain per-
ception was 3/10. e RS score decreased signicantly postoperatively
(mean: preop 5.3/7, postop: 4.1/7; p<0.001). A signicant loss of satisfac-
tion was seen in the areas of enjoyable food (p=0.002), social recognition
(p=0.029), external appearance (p=0.011) and independence (p=0.003).
Discussion: Supportive therapy measures to promote the physical and
mental tness of oral cancer patients are part of inpatient care at our
clinic. However, there is no structured monitoring of these therapies that
can be measured and compared.
Conclusion: Structured and measurable programmes to increase mental
and physical tness in both prehospital and inpatient care could lead to
an improvement in the quality of outcome. is might also improve the
comparability of treatment strategies and postoperative courses.
Disclosure Statement: e authors declare no conict of interest.
447
HPV-negative status has a greater impact on worse overall
survival than the smoking status in oropharyngeal cancer - a
population-based analysis in Germany from 2018 to 2020
Mussab Kouka1; Laura Gerlach1; Jens Büntzel2; Holger Kaftan3;
Daniel Böger4; Andreas Müller5; Thomas Ernst6; Orlando Guntinas-Lichius1
1Uniklinikum Jena/Klinik für Hals-, Nasen- und Ohrenheilkunde, Jena,
Deutschland
2Südharz Klinikum Nordhausen, Nordhausen, Deutschland
3Hals-, Nasen- und Ohrenheilkunde, Plastische Operationen | Helios Klinikum
Erfurt, Erfurt, Deutschland
4SRH Zentralklinikum Suhl gGmbH Klinik für Hals-, Nasen-, Ohrenheilkunde
-Plastische Operationen-, Suhl, Deutschland
5SRH Wald-Klinikum Gera, Gera, Deutschland
6UniversitätsTumorCentrum Jena am Universitätsklinikum Jena, Jena,
Deutschland
Background: e aim was to evaluate the interaction of human papilloma-
virus (HPV), smoking and alcohol status on oropharyngeal squamous cell
carcinoma (OPSCC) on overall survival (OS) in population-based setting.
Methods: In this retrospective cohort study, data of 498 patients with
OPSCC (mean age: 62.5 years; 77% male) from 2018 and 2020 were
included. Binary logistic regression analysis and Cox multivariable regres-
sion analysis were performed.
Result: OPSCC were 37.3% HPV-positive (+; among them 31.2% smok-
ers; mean incidence: 2.91/100,000 population) and 57.8% HPV-negative
(-; 63.5% smokers; mean incidence: 4.50/100,000 population). Median
follow-up was 20 months. HPV+ patients had signicantly better OS
than HPV- patients (HPV+: 2-year OS: 90.9%; HPV-: 2-year OS: 73.6%;
p < 0.001). In binary logistic regression analysis, smokers showed a 4.5
increased odds ratio (OR) of being tested HPV- than for nonsmokers (OR:
4.5; 95% CI: 2.76-7.35; p < 0.001). In multivariable analysis, HPV- patients
(hazard ratio (HR) = 4.5; 95% condence interval (CI): 2.4 - 8.6), patients
with a higher N classication (N2: HR = 3.3; 95% CI: 1.71 – 6.20; N3: HR
= 3.6; 95% CI: 1.75 -7.31) and with a higher cancer staging (III: HR = 5.7;
95% CI: 1.8 - 17.6; IV: HR = 19.3; 95% CI: 6.3 -57.3) had an increased haz-
ard of death (all p < 0.05). Smoking and alcohol habits had no signicant
independent eect on OS (smokers: HR = 1.1; 95% CI: 0.65 - 1.83; IV:
alcoholics: HR = 1.4; 95% CI: 0.87 - 2.3; both p > 0.05)
Discussion: Worldwide studies have reported an increase of HPV+
OPSCC. e result is that HPV+ has overtaken HPV- OPSCC in many
countries. In contrast, HPV+ OPSCC still is a minority in uringia, espe-
cially HPV+ OPSCC in non-smokers. Classical risk factors continue to
dominate and have greatest impact on OS.
Conclusion: It is more important to optimize therapeutic strategies for
HPV- OPSCC than to discuss de-escalation strategies for HPV+ patients.
Disclosure Statement: e authors declare no conict of interest.
449
Analysis of the tumor immune microenvironment of
advanced, non-adenoid cystic salivary gland cancer
Benjamin von der Emde1; Erika Zuljan2; Eric Blanc2; Iris Piwonski3;
Frederick Klauschen3; Ingeborg Tinhofer-Keilholz4; Andreas Mock5;
Peter Horak6; Ulrich Keller1; Konrad Klinghammer1; Stefan Fröhling6;
Sebastian Ochsenreither7; Ulrich Keilholz7; Dieter Beule2; Damian Rieke1
1Charité -CBF Klinik m.S. Hämatologie, Onkologie und Tumorimmunologie,
Berlin, Deutschland
2BIH, Berlin, Deutschland
3Charité - Institut für Pathologie, Berlin, Deutschland
4Charité - Klinik für Radioonkologie und Strahlentherapie, Berlin, Deutschland
5Uni München, München, Deutschland
6NCT Heidelberg, Heidelberg, Deutschland
7Charité Comprehensive Cancer Center, Berlin, Deutschland
Background: Salivary gland cancers (SGC) are a group of rare malig-
nancies. Systematic data on ecacy of immune checkpoint inhibition are
lacking for the heterogeneous group of non-adenoid cystic carcinomas.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts102
We analyzed the tumor immune microenvironment, molecular signa-
tures, and clinical outcomes of advanced non-adenoid cystic salivary
gland cancer to identify novel therapeutic strategies.
Methods: Cases of recurrent and/or metastatic non-ACC SGC from the
DKTK MASTER program were included in the analysis. Whole exome/
whole genome and transcriptome sequencing as well as clinical data were
analyzed.
Result: 42 cases of advanced SGC were identied (8 adenocarcinoma
NOS, 7 mucoepidermoid carcinoma, 6 basal cell carcinoma, 6 salivary
duct carcinoma, 3 acinic cell carcinoma, 3 carcinoma ex pleomorphic ade-
noma, 2 carcinosarcoma, 7 other entities). An inamed tumor immune
microenvironment in transcriptome data was identied in 36 percent
of the samples. e median tumor mutational burden (TMB) was 2.42
(0.033 – 8.5). No association was found between tumor inammation
and TMB or prior therapies. Immune checkpoint expression, including
PD-1, TIM-3, CTLA-4, LAG-3 and TIGIT, was identied in a subgroup
of patients. Response data for 7 patients receiving immune checkpoint
inhibition were available, one of which achieved clinical benet in two
treatment regimens, receiving Nivolumab and Ipilimumab, achieving sta-
ble disease for 46 and 10 months respectively. e patients tumor immune
microenvironment was described as T-cell predominant.
Discussion: An inamed tumor immune microenvironment and immune
checkpoint expression was identied in patient subgroups and could
guide novel immune therapy strategies.
Conclusion: Comprehensive molecular characterization should be con-
sidered for treatment stratication in these rare tumor types.
Disclosure Statement: DR has received consultant and/or advisory board and/or
speaker fees from Roche, Bayer, Bristol-Myers Squibb and Lilly
Disclosure Statement: e authors declare the following: DR has received
consultant and/or advisory board and/or speaker fees from Roche, Bayer, Bristol-
Myers Squibb and Lilly
513
Correlation between the mean dose of the parotid glands
with xerostomia and HRQoL in patients withhead and neck
cancer– an unicentre cross sectional study
Anke Breitling; Dirk Vordermark; Daniel Medenwald
Universitätsklinik für Strahlentherapie der Universitätsmedizin Halle/Saale,
Halle/Saale, Deutschland
Background: Intensity-modulated radiotherapy (IMRT) is a well established
option in the primary treatment of head and neck cancer. e close proxim-
ity of the parotid glands to the tumor and lymphonodes induces accidental
irradiation which causes acute or late toxicities such as salivary hypofunc-
tion, which results in xerostomia or sticky saliva. e aim of this study was to
detect the subjective perception of patients concerning health-related quality
of life (HRQoL) one year aer the treatment with radiotherapy either alone
or in combination with surgery, chemotherapy and/or cetuximab.
Methods: is study included 56 patients with cancer of the head and
neck. We used the EORTC QLQ-C30, EORTC QLQ-OH15, Groningen
Radiotherapy-Induced Xerostomia Questionnaire – GRIX to assess qual-
ity of life. In addition, we collected patient-, tumor- and therapy charac-
teristics and furthermore analyzed the CTCAE-Score for xerostomia.
Result: A higher burden of symptoms goes along with a reduced health-
related quality of life. We found a regression coecient ß = -0,184 (95% CI
0,356 and -0,012) for „GRIX xerostomia night“ and global quality of life.
Higher physician-reported grades of a dry mouth were associated with
higher scores (higher burden of the symptoms) in patient-reported xero-
stomia concerning day, total score and OH15 xerostomia. e spearman
correlation revealed medium-strength correlation between physician-
and patient-reported xerostomia.
Discussion: e grade of xerostomia, assessed by CTCAE seems to be a
poor predictor for HRQoL. ere is a need to implement patient-reported
burden within international classication.
Conclusion: Mouth-associated long-term side eects aect the health-
related quality of life one year aer treatment of head and neck cancer.
By analyzing in a dierentiated way when a specic mouth-associated
symptom deteriorates the patient-described quality of life, it is possible to
establish new strategies of supporting those patients.
Disclosure Statement: e authors declare no conict of interest.
573
Feasibility study OncSaliva – non-invasive specimen for the
detection of head and neck cancer via epigenetic markers
Anna-Bawany Hums1; Mussab Kouka2; Lars Jansen3; Matthias Dürst3;
Alfred Hansel1; Martina Schmitz1; Orlando Guntinas-Lichius2
1oncgnostics GmbH, Jena, Deutschland
2Department of Otorhinolaryngology, Jena University Hospital,
Jena, Deutschland
3Department of Gynecology, Jena University Hospital, Jena, Deutschland
Background: Head and neck squamous cell carcinoma (HNSCC) are
mainly diagnosed at advanced tumor stage aer the onset of symptoms.
Timely detection would improve the options for successful treatment.
Here, we investigate ve tumor-specic DNA methylation markers in the
current OncSaliva study to determine the clinical performance in non-in-
vasive specimen, such as saliva samples.
Methods: DNA methylation markers ZNF671, ZNF833, ZIC1, PAX6-1,
HOXA9 and bisulte-specic reference Beta-Actin were analyzed using
fresh-frozen tissue, saliva and swabs from HNSCC patients and controls.
Samples were bisulte-converted prior to methylation-specic multiplex
qPCR. Study goal is to include 100 controls and 100 HNSCC patients, the
latter with two-year follow-up examination.
Results: Up until now we analyzed fresh-frozen tissue and saliva from
51 HNSCC patients and 33 controls in the OncSaliva study. DNA meth-
ylation markers showed 75% sensitivity and 100% specicity, if three of
ve markers were required to test positive in tissue. Single-marker detec-
tion oered up to 83% sensitivity with 97% specicity. In saliva samples
the best single marker resulted in 71% sensitivity and 82% specicity. If
three out of ve markers were positive in saliva, 63% sensitivity and 91%
specicity could be reached. Comparison of tissue and saliva sample pairs
yielded 49% to 78% agreement for the HNSCC group and 73% to 100%
agreement in the control group. Data from swab samples and individual
patient follow-ups will be presented at the congress.
Conclusion: Preliminary results from marker validation and from recent
patient samples support our study hypothesis to robustly detect HNSCC
markers in both, tissue and saliva. Utilization of saliva samples for can-
cer-specic diagnostic assays based on epigenetic markers will be useful in
in vitro diagnostics aiming at secondary and tertiary prevention.
Disclosure Statement: e authors declare the following: Forschungsstudie
zwischen Uniklinikum Jena und oncgnostics GmbH & A.-B. Hums is employed as
an R&D scientist at oncgnostics GmbH.
597
Hybrid vascular graft prosthesis for vascular reconstruction
of the internal carotid artery near the skullbase after
radical excision of a very rare malignant Glomus-caroticum-
paraganglioma
Frank Meyer1; Christoph Arens2; Udo Barth3; Dörthe Jechorek4;
Zuhir Halloul3
1Dept. of General, Abdominal, Vascular and Transplant Surgery; University
Hospital, Magdeburg, Deutschland
2Dept. of Otorhinolaryngology, University Hospital (former aliation),
Magdeburg, Deutschland
3Division of Vascular Surgery; Dept. of General, Abdominal, Vascular and
Transplant Surgery; University Hospital, Magdeburg, Deutschland
4Institute of Pathology, University Hospital, Magdeburg, Deutschland
Background: Neck tumor (Tu) lesions are challenging regarding the
diagnostic & therapeutic management, in particular, in case of malignant
Tu growth & near relevant vessels to achieve R0 resection status for best
prognosis.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 103
Aim: To present the successful outcome of a demanding interdisciplinary
surgical approach (otorhinolaryngology & vascular surgery) because of a
necessary surgical re-intervention due to malignant Tu growth (detected
in the histopathologic investigation of the rst specimen) including vas-
cular resection using a hybrid gra for vascular reconstruction of the
internal carotid artery near the skullbase.
Method: Scientic case report.
Result (case description): A 38-years old male patient underwent diag-
nostics (MRA & DSA) to clarify diagnosis of a Tu lesion at the right neck,
which was preoperatively embolized & subsequently resected including
vascular reconstruction using a prosthetic interponate (7 cm; W.L. Gore
GmbH, Putzbrunn, Germany) between common & internal carotid
arteries - histology: malignant paraganglioma of 40 mm in diameter with
cancerous haemangiosis et lymphangiosis demonstrating lymph node
metastasis & prompting to re-operation (neck dissection [level II, III,
IV, V] followed by novel vascular reconstruction using GORE® Hybrid
Vascular Gra prosthetic stent [W.L. Gore GmbH] as interponate because
of the short extracranial stump of the distal internal carotid artery near
the skullbase & to limit clamping time). Early postoperative outcome
revealed no complications; aer 12 months, there were no signs & symp-
toms of recurrent Tu growth.
Conclusion: Extended resections – if necessary including vascular
(arterial) segments aim at achieving R0 classication as shown in this
extremely rare & usually challenging malignant Tu lesion. Hybrid vascular
prostheses are suitable for time-saving vascular reconstruction to repro-
vide sucient blood supply.
Disclosure Statement: e authors declare no conict of interest.
618
Prognostic value of tumor budding in salivary gland
carcinoma
Valentin Burkhardt1; Gian Kayser2; Christoph Becker1
1Universitätsklinikum Freiburg/HNO, Freiburg, Deutschland
2Gemeinschaftspraxis für Pathologie Freiburg, Freiburg im Breisgau,
Deutschland
Background: A high tumor budding score in low-grade major salivary
gland carcinoma (MSGC) seems to lead to higher T and N stages, recur-
rences and an impaired disease-free survival. Treatment of low-grade
(MSGC) consists regularly of sole surgical therapy of the salivary gland
without elective neck dissection in T1/2 carcinomas or adjuvant radiation
therapy (RT).
Methods: We analyzed retrospectively data of 71 patients with either low-
grade MSGC with a high tumor budding score and high grade MSGC
from 2003 to 2017 in a single center study. Pathological risk factors and
TNM classication were reviewed for each case. All HE-stained histologi-
cal specimen were reviewed and tumor budding was determined.
Result: Kaplan-Meier analysis of overall survival showed 84.7 months
(CI: 55.8;113.6) in the low grade/high tumor budding group and 56.2
months (CI: 40.6;71.8) in the high grade group (log-rank p<0,05). Cox
regression revealed a signicant inuence of the age (p<0.05), whereas the
grading had no signicant inuence (p>0.05). e disease-free survival
accounts for 75.5 months (CI: 54.7;96.2) in the low grade group and 78.5
months (CI: 55.1;101.9) in the high grade group (log-rank p<0.05). Cox
regression showed no statistically signicant inuence of age or grading
(bothp>0.05).
Discussion: e current debate about treating MSGCs with less extended
surgical procedures holds benets and risks for the patients. Whereas
therapy of high-grade MSGC includes surgical resection, elective neck
dissection as well as adjuvant RT, therapy of low-grade MSGC without
nodal metastasis has an excellent outcome in terms of OS and DFS. Tumor
budding might function as an additional prognostic factor in low-grade
MSGC as it seems to be associated with higher recurrence rates compared
to high grade salivary gland carcinomas.
Conclusion: Tumor budding might help to reduce therapy reduction in
low-grade MSGC with a higher risk of occult metastasis and locoregional
recurrence to optimize therapy and outcome.
Disclosure Statement: e authors declare no conict of interest.
808
Vitamin D receptor as a non-invasive predictor for laryngeal
squamous cell carcinoma
Olaf Wendler1; Marlen Haderlein2; Michael Koch1; Matti Sievert1;
Matthias Balk1; Robin Rupp1; Antoniu-Oreste Gostian1; Abbas Agaimy3;
Rainer Fietkau2; Heinrich Iro1; Sarina Müller1
1Department of Otolaryngology, Head and Neck Surgery, Universitätsklinikum
Erlangen, Erlangen, Deutschland
2Department of Radiation Oncology, Universitätsklinikum Erlangen, Erlangen,
Deutschland
3Department of Pathology, Universitätsklinikum Erlangen, Erlangen,
Deutschland
Purpose: e vitamin D receptor (VDR) is responsible for the expression
of numerous genes including cell proliferation and dierentiation. Along
with vitamin D itself it is subject of clinically driven research. However,
its role as non-invasive marker for laryngeal squamous cell carcinoma
(LSCC) has never been investigated. erefore, the objective of this study
was to analyze the potential of VDR as non-invasive serum marker for
LSCC.
Methods: IRB approved study of n=49 controls and n=75 LSCC who
underwent a panendoscopy for tumor staging, a biopsy and blood sam-
pling. According to the TNM staging system 8th version dierent tumor
sizes of LSCC (T1-4a) were included. VDR was analyzed in tissue using
Immunohistochemistry (IHC) and Immunouorescence (IF). In the fol-
lowing, results were validated using Western Blots (WB). Finally, serum
VDR was analyzed using ELISA.
Results: VDR was signicantly overexpressed in tissue of LSCC patients as
shown in WB (p=0.008). Moreover, VDR was signicantly overexpressed
in serum of LSCC patients with higher serum levels in larger tumor sizes
(e.g. T1/2 p<0.045, T3/4 p<0.001).
Discussion and conclusions: VDR showed a signicant overexpression
in tissue as well as in serum of LSCC patients in all tumor sizes. For this
reason, VDR may be a potential non-invasive predictor for advanced size
LSCC but more importantly also for early stage LSCC. Further studies are
needed to investigate the clinical meaningfulness.
Disclosure Statement: e authors declare no conict of interest.
831
Rad51 in breast cancer brain metastases
Johanna Schaser; Falko Schwarz; Christian Senft; Peter Baumgarten;
Diana Freitag
Universitätsklinikum Jena, Klinik für Neurochirurgie, Jena, Deutschland
Background: Breast cancer (BC) is the most common form of cancer in
women. Breast cancer brain metastases (BCBM) are late complications
with poor prognosis. e DNA repair gene Rad51 is associated with
aggressive behavior and chemotherapy resistance in BC. We aimed to
analyze this factor as a potential prognostic marker to predict overall and
progression-free survival.
Methods: We examined the mRNA prole in tissue of BCBM patients
(n = 18). Using qPCR, we analyzed expression levels of Rad51, CDH1,
CDH2 and BC-specic markers (HER2) in these samples as well as healthy
breast and brain tissue. Clinical and survival data were analyzed regarding
the genetic tumor prole. For statistics, Mann-Whitney-U-tests, ROC-,
Kaplan-Meier-analysis and Spearman-correlations were used.
Results: Factors like patient age and tumor localization did not markedly
aect overall survival. A higher expression of Rad51 was found to result
in signicantly lower overall (p = 0,047) and BCBM-free patient survival
(p = 0,025). We observed an increase in BCBM-free survival in patients
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts104
with high expressions of CDH1 (p = 0,029) and HER2 (p = 0,004). e
expression levels of CDH1 showed a signicant inverse correlation to
those of CDH2 (p = 0,032).
Discussion: e association of decreased survival and increased Rad51
expression points to a protective eect of Rad51 on the tumor environment,
resulting in disease progression. However, higher HER2 and lower CDH2
expression seem to be positive prognostic factors in predicting BCBM-free
survival. e epithelial marker CDH1 may indicate a less aggressive pheno-
type, possibly marking a resting tumor cell state aer epithelial mesenchy-
mal and mesenchymal epithelial transition during metastatic spread.
Conclusion: e signicant negative impact of high Rad51 expression
on overall and BCBM-free survival indicates that Rad51 may serve as an
interesting therapeutic target not only in primary BC but also in BCBM.
Disclosure Statement: e authors declare no conict of interest. is study is
funded by the Interdisciplinary Centre for Clinical Research (IZKF) Jena.
Disclosure Statement: e authors declare no conict of interest.
875
Impactand treatment pattern of second-line therapy in
patients with recurrent or metastatic head and necksquamous
cell carcinoma (r/m SCCHN) – a German multicenter
retrospective study (HEAT)
Michael Pogorzelski1; Konrad Klinghammer2; Thomas Hilser1;
Marcel Bourgeois3; Tessa Hattenhauer4; Rebekka Mispelbaum4;
Jonas Wiegmann3; Eyck von der Heyde5; Kerstin Lüdtke-Heckenkamp6;
Jens Atzpodien6; Justyna Rawluk7; Philipp Ivanyi8; Stefan Kasper-Virchow1;
Balint Tamaskovics9; Mareike Tometten3; Viktor Grünwald1,10
1Innere Klinik (Tumorforschung), Westdeutsches Tumorzentrum,
Universitätsklinikum Essen, Essen, Deutschland
2Klinik für Hämatologie und Onkologie, Charité Campus Benjamin Franklin,
Berlin, Deutschland
3Klinik für Hämatologie, Onkologie, Hämostaseologie und
Stammzelltransplantation (Med. Klinik IV), Uniklinik RWTH Aachen, Aachen,
Deutschland
4Hämatologie und Onkologie, Medizinische Klinik III, Universitätsklinikum Bonn,
Bonn, Deutschland
5Onkologie am Raschplatz, Hannover, Deutschland
6Internistische Onkologie und Hämatologie, Niels-Stensen-Kliniken, Franziskus-
Hospital Harderberg, Georgsmarienhütte, Deutschland
7Klinik für Innere Medizin I, Hämatologie, Onkologie und
Stammzelltransplanation, Universitätsklinikum Freiburg, Freiburg, Deutschland
8Klinik für Hämatologie, Hämostaseologie, Onkologie und
Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover,
Deutschland
9Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum
Düsseldorf, Düsseldorf, Deutschland
10Klinik für Urologie, Westdeutsches Tumorzentrum, Universitätsklinikum Essen,
Essen, Deutschland
Background: Immune checkpoint inhibitors (CPI) are a rst-line (1L)
standard in patients (pts) with PD-L1 positive recurrent/metastatic squa-
mous cell carcinoma of the head and neck (r/m SCCHN). Cetuximab-
based chemotherapy (CTx) remains the standard of care for PD-L1
negative pts. Second-line (2L) options remain variable. We retrospectively
evaluated treatment patterns and ecacy of second-line (2L) therapy in
r/m SCCHN pts treated at German head and neck cancer centers.
Methods: Pts with r/m SCCHN who started palliative 1L therapy between
12/2019 and 12/2021 were eligible. Data were retrospectively collected in
nine centers and retrieved from medical records. Database was closed on
May 1st, 2023. Overall response rate (ORR) was evaluated according to
RECIST 1.1. Kaplan–Meier method, log rank test and Cox proportion-
al-hazard model were applied.
Result: In total, 179 pts were included. Baseline characteristics were:
median age 64.0 years, 25.7% female, 32.8% ECOG PS ≥ 2, main primary
location was oropharynx in 34.1%, (p16: positive 19.7%) followed by
oral cavity (26.8%). Median overall survival (OS) from start of 1L ther-
apy was 17.0 months (m) (95% CI 15.0 – 22.1). In 1L, 67.6% received
CPI monotherapy, 18.7% CPI/CTx and 13.0% cetuximab/CTx. At data
cut-o, 139 pts (78.5%) were progressive to 1L therapy. Of those, 47.4%
(N=66) received a 2L therapy with ORR of 37.9%, progression-free sur-
vival (PFS) of 3.8m and OS of 9.7m from start of 2L. Pts who received a
cetuximab-based regimen (68.5%) aer failure of 1L CPI-based therapy
had superior PFS (5.6 vs 2.2m; P = 0.01) and OS (11.4 vs 4.9m; P < 0.001)
vs those pts who received a non-cetuximab 2L regimen.
Discussion: Second-line therapy is initiated in approximately 50% r/m
SCCHN pts in a real-world setting. Cetuximab-based therapy showed
greater clinical activity aer 1L CPI failure. e retrospective nature of
our analysis and the selection of pts are major limitations.
Conclusion: Cetuximab-based therapies show promise aer CPI failure.
Prospective studies evaluating the role of cetuximab following CPI failure
are warranted.
Disclosure Statement: e authors declare the following: Consultancy, Honoraria
and Travel Support: Boehringer Ingelheim, Bristol Myers-Squibb, Lilly, Merck
Healthcare KGaA, Merck Sharp & Dohme, Roche, Sano Aventis, Servier.
880
The correlation between oral mucositis and oncological
outcomes in patients undergoing radiation therapy for head
and neck cancer: a prospective study
Elsa Beatriz Monroy Ordonez; Andreas Thomsen; Michael Henke;
Raluca G. Stoian; Henning Schäfer; Anca-L. Grosu; Tanja Sprave
Klinik für Strahlenheilkunde Universitätsklinikum Freiburg, Freiburg im
Breisgau, Deutschland
Background: e correlation between oral mucositis and oncological out-
comes in patients undergoing radiation therapy for head and neck cancer:
a prospective study
Methods: 84 patients treated with primary or adjuvant radio(chemo)ther-
apy for locally advanced squamous cell carcinoma of the head and neck
at the Department of Radiation Oncology, University Hospital Freiburg,
Germany, were included. e main focus was a predened recording
of mucositis. For this purpose, a clinical examination of the patients was
performed twice a week by a specially trained examiner. is involved sys-
tematic examination of the eight regions of the oral mucosa: hard and so
palate, tongue, oor of the mouth, upper and lower lip, le and right buccal.
Tumor control rate was recorded during regular oncological follow-up.
Result: e median follow-up was 19 months. 62 (73.8%) participants
received primary denitive therapy and 22 (26.2%) patients received
adjuvant radio(chemo)therapy. e most common tumor locations were
oropharynx n=37 (44%), oral cavity n=22 (26.2%), and hypopharynx
n=20 (23.8%). Median dose was 69.3 Gy (range 52-70 Gy). 47 participants
developed grade 3 oral mucositis aer a median dose of 32 Gy. e col-
lective was stratied by mucositis grade 3 vs. w/o mucositis grade 3. ere
was no signicant dierence in overall survival and progression-free
survival between both groups (log-rank p=0.15 and log-rank p=0.29).
e cumulative incidence of locoregional failures was also not dierent
between the two arms (n=8 in each arm, log-rank p=0.75). e cumula-
tive incidence of distant metastases was not signicantly dierent between
arms (n=9 in the mucositis grade 3 group vs. n=6 w/o mucositis grad 3
group, log-rank p=0.72).
Conclusion: e high-grade oral mucositis does not appear to compro-
mise oncologic response. is nding will be validated in larger multi-
center collectives.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 105
933
Coherence between macrophage inltration/polarisation and
the immune checkpoints of the PD1/PD-L axis in the induction
of immunosuppression in oral mucosal lesions
Manuel Weber; Rainer Lutz; Marco Kesting; Jutta Ries
Mund-, Kiefer- und Gesichtschirurgische Klinik Erlangen, Erlangen, Deutschland
Background: Immune checkpoint inhibitors (ICI), particularly inhib-
itors of the PD1/PD-L1/PD-L2 axis have become extremely prominent
in tumor therapy. It is shiwn the immune checkponts as well as tumor
inltrating macrophages and their polarization towards the immunosup-
pressive M2-like type are relevent for mlignant transformation and pro-
gression of oral squamous cell carcinomas (OSCC). Aim of this study was
to clarify whether increased expression of the immune checkpoints of the
PD1 axis are associated with increased inltration of macrophages and the
shi towards M2 polarization.
Material and Methods: A total of 178 tissue samples were included.
102 oral leukoplakia (OLP) (non-transforming OLP=53, transform-
ing OLP=49), 48 OSCC and 48 healthy oral mucosa samples (NOM).
Expression levels of CD68 (generic macrophage marker), CD11c (M1)
and CD163 (M2) as well as PD1, PD-L1 and PD-L2 were quantied
by immunohistochemistry (IHC). Correlation was tested using the
Spearman-Rho test.
Results: In the epithelium, macrophage inltration (CD68) and
increased expression of PD1, PD-L1 and PD-L2 correlated signicantly.
Additionally, in the epithelium the polarisation of macrophages towards
M2 correlated with the overexpression of PD-L1. Epithelial expression
of CD163 and CD11c was correlated with overexpression of PD-L1 and
PD-L2. Subepithelially, the expression of PD1 and CD68, CD163 and
CD11c correlated moderately.
Conclusion: In the present study, a positive correlation was found in oral
mucosal lesions between the expression of PD1/PD-L1 axis and macro-
phage inltration and polarization towards M2. ese results suggest that
the increased expression of the checkpoints could promote the recruit-
ment of TAMs or vice versa. is could trigger immunosuppression and
possibly tumour initiation and progression.
Disclosure Statement: e authors declare no conict of interest.
938
Two Heads Are Better Than One: Interobserver Variability of
Tumor Contouring in the Prospective NAVIGATORR Trial
Lukas Bauer1; Sebastian Regnery1; Reinald Kühle2; Jennifer Fuchs2;
Julius Moratin2; Florian Stritzke1; Philipp Schröter1; Katharina Weusthof1;
Maximilian Deng1; Sebastian Adeberg3; Jürgen Homann2; Jürgen Peter
Debus1; Christian Freudlsperger2; Thomas Held1
1Abteilung für Radioonkologie und Strahlentherapie, Univiversitätsklinik
Heidelberg, Heidelberg, Deutschland
2Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie,
Universitätsklinikum Heidelberg, Heidelberg, Deutschland
3Klinik für Strahlentherapie, Universitätsklinikum Marburg, Marburg,
Deutschland
Background: Careful review of preoperative imaging is essential to
achieve complete resection of locally-advanced head-and-neck cancers
(HNC). In the prospective clinical NAVIGATORR trial we establish a
new interdisciplinary workow. Here we assess interobserver variability
in tumor contouring in preoperative imaging and its possible impact on
intraoperative navigation.
Methods: NAVIGATORR is a prospective clinical trial that enrolls 60
patients with locally-advanced HNC of the skull base. Patients undergo
tumor resection with an intraoperative optical navigation system
(Brainlab, Munich, Germany). Tumor contouring in preoperative imaging
(MRI) is done seperately by an oral and maxillofacial surgery (OMS)
specialist and a radiation oncologist. Subsequently, dierences in tumor
contouring between specialities are discussed. To evaluate dierences in
tumor contouring, we compared tumor volumes and calculated the Dice
similarity coecient (DSC) and the 95th percentile of the Hausdor dis-
tance (HD95). DICE and HD95 were assessed on a spectrum from “Very
Poor” to “Good” based on prior research.
Result: So far, preoperative tumor contouring was done in six patients
that underwent navigation-based tumor resection. In comparison, tumor
volumes contoured by the OMS specialist were higher. DSC values showed
Good” and “Good-intermediate” overlap between tumor contours. HD95
values indicated “Good” and “Good-intermediate” agreement.
Discussion: Our early ndings support the feasibility and possible bene-
t of our interdisciplinary workow. However, NAVIGATORR remains a
project under development. We eagerly anticipate the availability of more
comprehensive and rened data.
Conclusion: Discussion of preoperative tumor volumes might enhance
oncological safe tumor resection.
Disclosure Statement: e authors declare the following: RK and CF previously
acted as advisors of Brainlab, Germany.
939
Increased PD1/PD-L1/2 expression is linked to MAGE-A
expression during oral cancer development
Manuel Weber; Rainer Lutz; Marco Kesting; Jutta Ries
Mund-, Kiefer- und Gesichtschirurgische Klinik Erlangen, Erlangen, Deutschland
Background: MAGE-A tumor antigen expression is restricted to malig-
nant and promptly malignant transforming oral mucosa. MAGE-A anti-
gens can act as neoantigens and cause an immune reactions. However,
immunologic clearance of MAGE-A expressing cells is not successful
when oral squamous cell carcinomas (OSCC) develop from precursor
lesions, oral leukoplakias (OLP). Local immunosuppression via the PD1/
PD-L1/2 axis might contribute to immune evasion of MAGE-A express-
ing cells during malignant transformation. e aim of this study was to
determine whether reactivation of MAGE-A expression in oral epithe-
lium during malignant transformation is associated with expression PD1/
PD-L1/PD-L2 axis.
Material and Methods: A total of 221 tissue samples were included: OLP
(n=134), OSCC (n=50) and healthy oral mucosa (NOM, n=37). In all
samples, the expression of MAGE-A antigens was determined by immu-
nohistochemistry (IHC) using 57b antibody and they were divided into 2
groups, positive and negative for MAGE-A. Expression of PD-1, PDL-1
and PD-L2 were determined by RT-qPCR and IHC.
Results: MAGE-A expression was signicantly associated with tissue
inammation level (p=0.001). RT-qPCR showed signicant overexpres-
sion of the ligands, PD-L1 and 2 in MAGE-A positive and in inamed
tissue (p=0.001). Expression of the immune checkpoints demonstrated
signicantly increased expression of PD-L1 (p=0.01) and PD-L2 (p=0.004)
in the epithelium of the MAGE-A positive group. e degree of inam-
mation was signicantly associated with the increased expression of the
ligands in the epithelium (pPD-L1=0.0001, pPD-L2=0.001) and the receptor
PD1 in the subepithelium (pPD1=0.04).
Conclusions: Increased expression of the immune checkpoint pathway
PD1/PD-L1/2 is statistically signicantly coupled to MAGE-A expres-
sion in oral epithelium and during oral carcinogenesis. is may indicate
that MAGE-A induces immunosuppression via the PD1 axis, preventing
immunologic clearance of MAGE-A expressing cells promoting malig-
nant transformation.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts106
942
BTLA: An immune modulator of local immunosuppression and
a potential target for (combination) immunotherapies in oral
cancer
Leah Trumet1; Manuel Weber2; Rainer Lutz2; Marco Kesting2; Jutta Ries2
1Zahnklinik 1, Erlangen, Deutschland
2Mund-, Kiefer- und Gesichtschirurgische Klinik Erlangen, Erlangen,
Deutschland
Background: In oral squamous cell carcinoma (OSCC), a complex immu-
notolerant microenvironment can be observed. Only a small proportion
of patients respond to immune checkpoint inhibitors against PD1/PD-L1.
erefore, new therapeutics, especially immunological combination ther-
apies, must be developed.
e inhibitory immune checkpoint BTLA is upregulated in many tumour
entities and correlates negatively with prognosis. erefore, it is consid-
ered a potential target for antibody-based immunotherapy. Moreover,
BTLA is already targeted in experimental combination ICI studies.
e aim of the study was to examine whether the immune checkpoint
BTLA is overexpressed in tissue samples from OSCC-patients compared
to healthy volunteers (NOM) and if its expression is correlated with the
PD1 axis.
Material and Methods: 102 tumor tissue samples of initial diagnosed
OSCC patients and 105 oral mucosa tissues (NOM) were included. e
expression of BTLA-1/2, as well as of PD1, PD-L1 and 2 were determined
by RT-qPCR. e expression of BTLA protein was also quantied by
immunohistochemistry. e expression levels were compared between
both groups, relative expression dierences were calculated and the sta-
tistical relevance of dierential gene expression was determined. e
expression of BTLA was correlated to expression levels of the PD axis
modulators using Spearman-Rho test.
Results: BTLA expression was signicantly increased in tissue of OSCC
compared to NOM (PBTLA_1= 0.003; PBTLA_2= 0.0001, PIHC=0.003). e
expression of PD1 and its ligands was signicantly increased in OSCC.
ere was a strong correlation between BTLA and the expression of
checkpoints PD-1, PD-L1 and PD-L2.
Conclusions: BTLA is upregulated in OSCC compared to healthy mucosa.
BTLA expression correlates signicantly with PD1 and PD-L1/2 and
appears to be a potentially relevant local immune checkpoint in OSCC.
Antibodies against BTLA could be used as potential candidates, especially
in combination with ICI against the PD1 axis, for immunotherapies in
OSCC.
Disclosure Statement: e authors declare no conict of interest.
950
Inuence of MAGE-A expression in oral mucosal lesions on
macrophage invasion and polarization
Jutta Ries; Rainer Lutz; Marco Kesting; Manuel Weber
Mund-, Kiefer- und Gesichtschirurgische Klinik Erlangen, Erlangen, Deutschland
Background: Pre-/malignant cells express tumor antigens trough which
they are recognised by the immune system as foreign and destroyed by
triggered immune reactions. However, long-lasting immune reactions
are dampened by immune modulators, but also by immune cells such
as macrophages. In the oral cavity, the expression of MAGE-A antigens
is restricted to malignant and promptly transforming tissues, trigger-
ing a strong, long-lasting immune response that ultimately leads to an
immunosuppressive environment. In addition, a shi in macrophage
polarisation towards M2 has been observed in tumours and transform-
ing leucoplakias, which suggests local immunosuppression. e aim of
this study was to test whether reactivation of MAGE-A expression has an
inuence on the immunosuppression induced by macrophage inltration
and M2 polarization in the tissue.
Material and Methods: 134 leucoplakias, 50 tumors and 49 healthy oral
mucosa samples were analyzed. e expression of MAGE-A antigens 1-6,
10 and 12 was investigated by immunohistochemistry (IHC) with the
antibody 57b. Subsequently, the samples were divided into MAGE-A pos-
itive and negative. e expression levels of CD68 (macrophages), CD11c
(M1) and CD163 (M2) were quantied by IHC and compared between
both groups. e statistical relevance of the expression dierences was
determined. Epithelium and subepithelium were analyzed separately.
Results: ere was a signicant overexpression of CD68 in epithelium
and subepithelium of MAGE-A positive compared to negative samples
(p=0.001, FCE=2.5; FCS=1.2) indicating increased macrophage-inltra-
tion. e signicant overexpression of CD163 in the MAGE-A express-
ing group indicates M2 polarization and thus local immunosuppression
(pCD163_E=0.001, FCCD163_E=3.5; pCD163_S=0.007).
Conclusions: MAGE-A expression is accompanied by increased macro-
phage inltration and M2 polarization. is may cause a local immuno-
suppressive environment preventing an eective immune reaction against
MAGE-A expressing cells during malignant transformation of oral epi-
thelial cells.
Disclosure Statement: e authors declare no conict of interest.
951
The role of the transcription factor Oct-4A in the initiation and
progression of head-and-neck tumors
Jutta Ries1; Christoph Baran1; Emeka Nkenke2; Abbas Agaimy3;
Claudia Wickenhauser4; Manuel Weber1
1Mund-, Kiefer- und Gesichtschirurgische Klinik Erlangen, Erlangen,
Deutschland
2Allgemeines Krankenhaus der Stadt Wien, Wien, Österreich
3Pathologie des Uni-Klinikums Erlangen, Erlangen, Deutschland
4Universitätsklinikum Halle-Saale Institut für Pathologie, Halle (Saale),
Deutschland
Background: Oct-4 (POU class 5 homeobox 1) is considered one of the
main regulators responsible for maintaining pluripotency and self-renewal
of embryonic stem cells. Several studies have shown that Oct-4 is overex-
pressed in adult somatic stem cells, cancer precursor cells of precancerous
lesions (OLP) and in cancer stem cells of solid tumours. us, it may play
a role in the initiation and progression of carcinomas, including head and
neck squamous cell carcinoma (cancer stem cell hypothesis). However,
these results are controversial. In many studies, expression analysis did
not distinguish between individual isoforms of Oct4 generated by alterna-
tive splicing and referred to as Oct4A, Oct4B and Oct4B1. However, only
the nuclear-specic Oct4A isoform, as a transcription factor, regulates the
pluripotent nature of stem cells. erefore, to elucidate its expression and
biological signicance, it is important to distinguish between the dier-
ent isoforms. e aim of this study was to exclusively analyze the expres-
sion of the transcription factor Oct-4A in healthy oral tissue (NOM), oral
squamous cell carcinomas (OSCC), OLP, in cell cultures of enriched oral
cancer stem cells, to determine the importance of this isoform in OSCC.
Material and Methods: Oct-4A expression was analyzed in forma-
lin-xed, paran-embedded samples from 191 OLP, 88 OSCC and 19
NOM samples by immunohistochemistry (IHC) and RT-PCR using an
Oct4A-specic antibody and isoform-specic primers. Fluorescence-
based cell sorting enriched stem cells of OSCC cell cultures were exam-
ined by FACS and RT-PCR.
Results: Oct-4A was rarely expressed. 2.7% of all samples stained specif-
ically in IHC and no expression of Oct-4a could be shown in any of the
samples eg. OSCC cell cultures examined by RT-PCR.
Conclusion: e results may indicate that the transcription factor Oct-4A
plays a minor role in the initiation and progression of OSCC. However, it
could also be postulated that stem cells occur very rarely in somatic, pre-
cancerous, and malignant tissues and therefore cannot be detected, even
with highly sensitive methods.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 107
Health Economy/Public Health
27
Sexual and Gender Minorities and Cancer in Germany: Making
the Health Needs of Lesbian, Gay, Bisexual and Transgender
People visible
Gabriele Dennert1; Ulrike Boehmer2
1Fachhochschule Dortmund, Dortmund, Deutschland
2Boston University School of Public Health, Department of Community Health
Sciences, Boston, USA
Background: e health – and in particular: cancer-related health – of
sexual and gender minority (SGM) or LGBT (lesbian, gay, bisexual,
transgender) populations remains a largely neglected topic in Germany.
is presentation will focus on SGM populations’ cancer-related health
in Germany by providing an overview of the available evidence, gaps in
existing data, and recommendations to improve cancer-related health
among SGM/LGBT populations. (1)
Methods: An extensive literature review was conducted on the available
data about SGM populations and cancer in Germany. e cancer control
continuum (2) served as a framework for the available evidence on cancer
risk factors, prevention, early detection, diagnosis, treatment, survivor-
ship, and end-of-life care among SGM populations.
Result: SGM populations experience unique health inequities in
cancer-related health in Germany. ere is a striking discrepancy between
the highly developed resource-intensive healthcare system and the com-
plete lack of SGM perspectives and awareness about SGM populations in
oncology.
Discussion: ere is a need to broaden the understanding of SGM and
cancer. Discrimination in health care and especially intersectional dis-
crimination has been described as a barrier to access to high-quality care
in Germany and likely negatively impacts SGM individuals’ quality of
cancer care.
Conclusion: Interventions and policies are needed to improve SGM peo-
ples access and quality of cancer care.
Indication of source:
1 Dennert, G. (2022): Sexual and Gender Minorities and Cancer in Germany:
e Striking Absence of Understanding eir Cancer-related Needs. In:
Boehmer, U. / Dennert, G. (Eds.): LGBT Populations and Cancer in the Global
Context. Springer, 2022: 189–213.
2 National Cancer Institute (2020): Cancer Control Continuum. https://
cancercontrol.cancer.gov/about-dccps/about-cc/cancer-control-continuum
(accessed: 23.08.2023).
Disclosure Statement: e authors declare no conict of interest.
134
Carbon emission estimates from breast cancer patient travel
to German Radiation Centers
Ahmed Bedir1; Steen Weimann2; Matthias Mäurer2; Dominik Hering3;
Maximilian Grohmann4; Michael Oertel3; Tobias Gauer4; Daniel
Medenwald1; Christoph Straube5
1Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Halle (Saale),
Halle (Saale), Deutschland
2Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Jena,
Jena, Deutschland
3Klinik für Strahlentherapie - Radioonkologie, Universitätsklinikum Münster,
Münster, Deutschland
4Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum
Hamburg-Eppendorf, Hamburg, Deutschland
5Klinik für Radioonkologie und Strahlentherapie, Klinikum Landshut, Landshut,
Deutschland
Background: Travel-related emissions are becoming a signicant concern
in the context of climate change. Traditional cancer treatment procedures,
such as external beam radiotherapy (EBRT), require patients to travel
extensively, signicantly contributing to carbon emissions. is study
aims to quantify carbon dioxide (CO2) emissions from patient travel
for breast cancer treatment at University Hospital Magdeburg (UKMD),
Medical Center Landshut (KL) and University Medical Center Hamburg-
Eppendorf (UKE) in Germany.
Methods: We analyzed the geographic data of breast cancer patients visit-
ing the radiotherapy clinic in UKMD, KL and UKE, calculating distances
using Google Maps. CO2 emissions were estimated assuming the use of a
standard 40 mpg petrol car emitting 0.168 kg of CO2 per km.
Result: Addresses from 2709 breast cancer patients treated between 2018-
2022 were analyzed (UKMD 1177; KL 617; UKE 915 patients). Our sam-
ple traveled on average 36.3 km for each radiation fraction during that time
period (average distance UKMD 50.2 km; KL 42.6 km; UKE: 14.2 km). is
yielded an estimated total of 6.1 kg of CO2 emissions per travel visit, resulting
in 152.5 kg emissions assuming 25 visits (planning, treatment, follow-up).
Discussion: e study points to the environmental impact of frequent
travel for EBRT. Limitations include the assumption of a single transpor-
tation method, unaccounted route alterations, and the potential inaccu-
racy of patient addresses. e study also standardizes the number of visits
to 25, but actual visit counts and transportation methods could aect real-
world emissions.
Conclusion: Several countries have transitioned to fewer fractions to cut
down health care costs and improve patient comfort without compromis-
ing treatment outcomes. Reducing the number of fractions to ve, for
instance, could substantially reduce the total travel distances and conse-
quently, CO2 emissions.
Disclosure Statement: e authors declare no conict of interest.
271
Real-time patient locating in a large oncology outpatient
center - proof of concept
Jan-Peter Glossmann1; René Tielsch-Nebel1; Beate Bergatt-Kuhl1;
Thomas Zander1; Jürgen Wolf1; Michael Butler1; Cornelia von Levetzow1;
Andreas Melzner1; Peter Weuthen2; Klaus Lipka2; Peter Heinen2;
Michael Hallek1
1CIO Cologne, University Hospital Cologne, Center for Integrated Oncology
Aachen Bonn Cologne Duesseldorf (CIO ABCD), Köln, Deutschland
2medfacilities GmbH, Köln, Deutschland
Background: Outpatient cancer care is a complex process requiring
patients, sta and treatment to be at the right time at the right place. Real-
time locating systems (RTLS) are in-house tracking systems that can track
patient location live. Generated data can be analyzed to improve the pro-
cess, quality and safety of care.
Methods: A RTLS system for cancer patients has been implemented at
the Center for Integrated Oncology ambulatory in Cologne, Germany.
Areliable RTLS was prerequisite which required a high density of digital
receivers (anchors) for triangulation. e patient tracking devices use
Ultra-Wideband (UWB) technology allowing accurate real-time locating.
Patients consent for using tracking data was prerequisite.
Result: e main goal was to improve patient experience and reducing wait-
ing times. e RTLS system allowed observing patient movements visualized
on a digital oor map and process dashboard of the cancer outpatient center.
During the pilot 350 patients (cycles) were tracked and generated ca. 100.000
data points. Tracking positions were updated all 10 sec. Accuracy was 20 cm
if required. Data analytics included real-time process dashboards as well as
utilization times of therapy chairs. Process mining was done and was visual-
ized in heat maps as well as spaghetti plots.
Discussion: RTLS technology should be part of modern oncology
care. It helps to identify clinical ineciencies and optimize workows.
Implementing ndings can signicantly improve scheduling, cycle times,
utilization of therapy chairs and waiting times. Potential downstream
eects of these interventions include improved patient experience and
safety, economic eciency, opportunities for expanding clinical capac-
ity and avoiding sta burnout. Implementing such systems have chal-
lenges regarding technology, data protection, the need of patient and sta
compliance.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts108
Conclusion: Real-time patient tracking can successfully be implemented
in outpatient cancer centers and it oers great chances for improving care
and patient experience.
Disclosure Statement: e authors declare no conict of interest.
282
Inadequate subsequent therapies in oncology trials –
consequences for interpreting overall survival
Philip Böhler; Sascha Abbas; Philip Kranz
Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG), Köln,
Deutschland
Background: Overall survival results are only informative for patient care
if subsequent therapies aer disease progression or recurrence comply
with the current standard of care.
Methods: German benet assessments were used to illustrate the subse-
quent therapies administered in oncology trials compared to the current
standard of care in the adjuvant treatment of renal cell carcinoma (study
KEYNOTE-564; Pembrolizumab vs. Placebo) and non-small cell lung
cancer (study IMpower010, Atezolizumab vs. Best Supportive Care). e
interpretability of overall survival results was assessed.
Result: In the comparator arm, 30% (study KEYNOTE-564) and 42% (study
IMpower010) of the patients had disease recurrence. Subsequent treatment
complying with the standard of care (i.e. immune checkpoint inhibitors)
was only administered to 31% (study KEYNOTE-564) and 47% (study
IMpower010) of the patients with disease recurrence in the comparator arm.
Overall survival results were deemed not interpretable since standard of care
subsequent therapies were not given to a majority of patients.
Discussion: Overall survival is not only inuenced by the initial study
treatment but also by subsequent therapies aer disease recurrence or
progression. Subsequent treatment of patients aer recurrence in the
comparator arms in the studies KEYNOTE-564 and IMpower010 was
insucient because it did not reect the current standard of care. e
observed positive overall survival eects for the investigated interventions
are therefore unreliable.
Conclusion: For meaningful overall survival results, subsequent therapies
aer disease recurrence or progression need to reect the current stan-
dard of care. is is of particular importance in situations where superi-
ority of a drug was already proven in a later line of therapy. Trial sponsors
should ensure that subsequent therapies are in line with the standard of
care in future oncology trials.
Disclosure Statement: e authors declare no conict of interest.
350
Implementing the DigiNet intervention from a healthcare
management perspective
Leonie Eilers1; Vanessa Mildenberger2; Anika Kästner3; Anna Spier2;
Dusan Simic2; Stephanie Stock2; Wolfgang Homann3; Anna Kron4,5;
Florian Kron1,4,6; Jürgen Wolf4,5
1KCM KompetenzCentrum für Medizinoekonomie, FOM Hochschule für
Oekonomie & Management gemeinnützige Gesellschaft mbH, Essen,
Deutschland
2Institute for Health Economics and Clinical Epidemiology, Faculty of Medicine
and University Hospital Cologne, University of Cologne, Cologne, Deutschland
3Institute for Community Medicine, Section Epidemiology of Health Care and
Community Health, University Medicine Greifswald, Greifswald, Deutschland
4Department I of Internal Medicine, Center for Integrated Oncology (CIO)
Aachen Bonn Cologne, Faculty of Medicine and University Hospital Cologne,
Cologne, Deutschland
5National Network Genomic Medicine (nNGM) Lung Cancer, Faculty of Medicine
and University Hospital Cologne, Cologne, Deutschland
6VITIS Healthcare Group, Cologne, Deutschland, Cologne, Deutschland
Background: Molecular diagnosis and personalized treatment are
becoming inevitably critical in lung cancer care. Due to the complex-
ity, a well-structured documentation and close connection of healthcare
providers throughout the patient journeys is crucial but also costly. e
DigiNet intervention1 aims to improve care for patients with advanced
non-small cell lung cancer through the digital connection of healthcare
providers, an expert committee and the collection of patient-reported out-
comes. is study aims to identify the facilitating and inhibiting factors of
implementing the DigiNet intervention from a healthcare management
perspective.
Methods: A qualitative approach is applied in which healthcare providers,
including oncologists and study assistants, are interviewed at the begin-
ning of the intervention. A semi-structured interview guide was devel-
oped based on a systematic literature review. e data was analyzed using
qualitative content analysis, according to Mayring.
Result: Lacking resources regarding time and personnel, particularly
for the enrollment and documentation of patients and other admin-
istrative processes, were identied as inhibiting factors during the
implementation process of the DigiNet intervention. Furthermore, the
additional costs oen needed to be cross-nanced by other resources.
Facilitating factors included among others the motivation to participate
in the project.
Discussion: e projects primary eorts should be focused on the
improvement of patient care and its eciency. e necessary digitization
is a costly eort. us, more resources are required to implement this
intervention.
Conclusion: e study identied the determinants of change in the early
stages of introducing the DigiNet intervention into the health care system.
1 ClinicalTrials.gov. Identier NCT05818449 Improvement of Personalized Lung
Cancer Care rough Digital Connection and Patient Participation (DigiNet).
From: https://clinicaltrials.gov/study/NCT05818449.
Disclosure Statement: e authors declare no conict of interest.
408
Attitudes and concerns of persons with familial cancer risk
towards digital health technologies
Katharina Klein1; Paula Thomas1; Stephanie Stegen2; Stephen
Schüürhuis3; Sven Asmussen4; Nora Amirpour-Mehrhof5; Markus Feufel6;
Dorothee Speiser5; Christoph Kowalski7; Friederike Kendel1
1Charitè-Universitätsmedizin Berlin, Geschlechterforschung in der Medizin
(GiM), Berlin, Deutschland
2BRCA-Netzwerk e.V., Bonn, Deutschland
3Charité-Universitätsmedizin Berlin, Institut für Biometrie und Klinische
Epidemiologie, Berlin, Deutschland
4Humboldt-Universität zu Berlin, Lehrstuhl für Bürgerliches Recht,
Wirtschaftsrecht und Ökonomik, Berlin, Deutschland
5Charité-Universitätsmedizin Berlin, Zentrum Familiärer Brust- und
Eierstockkrebs, Klinik für Gynäkologie mit Brustzentrum, Berlin, Deutschland
6Technische Universität Berlin, Institut für Psychologie und Arbeitswissenschaft,
Berlin, Deutschland
7Deutsche Krebsgesellschaft e.V., Berlin, Deutschland
Background: e digital storage of health data in the electronic health
record (EHR) triggers intense discussions. Secure data storage is of great
importance, especially for persons with familial cancer risk (PFCR). It is
uncertain what attitudes PFCRs have towards the use of digital technologies.
As part of the development of a digital platform for PFCR (G-BA funded
project dVP_FAM, 01NVF20002), we investigated attitudes and concerns
regarding the introduction of an EHR. In addition, we assess whether PFCR
have diculties nding and evaluating health information online.
Methods: A cross-sectional online survey invitation was sent to individ-
uals at familial risk for cancer via the BRCA-Netzwerk e.V. e question-
naire included six items to assess attitudes toward the introduction of an
EHR. Identication of health information was assessed with the Digital
Health Literacy Instrument (1). Descriptive methods, statistical tests, and
correlation analyses were applied.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 109
Result: Two-hundred twenty-four Persons participated. Of the partic-
ipants, 71% (n=159) reported being able to nd health information on
the Internet. 66% (n=148) of the respondents felt able to distinguish reli-
able from questionable health information on the Internet. 64% (n=145)
expected that storing their health information in the EHR could improve
medical care. However, 42% (n=94) of participants also expressed con-
cerns about the security of having their health data stored in an EHR.
Discussion: e ndings highlights the importance of involving patients
in the development of digital health technologies to create solutions that
meet their needs and experiences.
Conclusion: e involvement of PFCR may promote the acceptance and
use of technologies, but also their eectiveness and long-term adaptability
in the changing healthcare environment.
1 Van Der Vaart R, Drossaert C. Development of the Digital Health Literacy
Instrument: Measuring a Broad Spectrum of Health 1.0 and Health 2.0 Skills.
JMed Internet Res. 2017:e27.
Disclosure Statement: e authors declare no conict of interest.
432
Decoding Patient Needs: Analyzing Media Portrayal of New
Cancer Drugs
Bettina Weniger; Bettina Linke; Marie-Jolin Köster
Deutsche Krebsgesellschaft, Berlin, Deutschland
Background: erapeutic options for cancer have greatly expanded in
recent years due to the development of numerous novel drugs. is study
deals with the presentation of these drugs in print media as well as with
information needs of cancer patients regarding new drugs.
Methods: A survey was conducted involving 80 cancer patients or their
relatives, along with a media analysis of six new cancer drugs. In addition,
a literature search on requirements for drug information for patients was
performed. Using the ndings, a set of criteria was formulated to oer
guidance in developing information for new drug introductions.
Result: e survey results show a substantial need for comprehensive
information about novel cancer drugs. Patients expressed the highest pri-
ority for details concerning both benets and risks. Respondents’ satis-
faction with the information on novel cancer drugs they received so far is
much lower than in other surveys with patients regarding general cancer
information. e media analysis shows there is little high-quality written
information on the selected drugs available for laypersons. In addition,
such information has little or no visibility on the internet. Furthermore,
its readability is poor. Articles are oen incomplete and sometimes unbal-
anced in terms of the benet-risk presentation.
Discussion: Due to the increasing prevalence and incidence of cancer, the
need for information on novel cancer drugs is expected to grow signi-
cantly in the near future. Existing information from print media is oen
incomplete and unbalanced. A small selection of information can be use-
ful for informative decision making for patients.
Conclusion: It is necessary to improve and to further develop drug informa-
tion for cancer patients. e awareness and visibility of high-quality infor-
mation should be increased and more independent, easy-to-understand, and
accessible information resources should be created. Moreover, it is important
to improve existing services in terms of content and readability.
Disclosure Statement: e authors declare no conict of interest.
525
Next-generation sequencing for sepsis diagnosis -A budget
impact analysis in the treatment of hemato-oncological
patients
Ann-Cathrine Siefen1; Jannis Trümmler1; Florian Jakobs1,2; Florian Kron1,3,4,5
1VITIS Healthcare Group, Köln, Deutschland
2Department of Hematology and Stem Cell Transplantation, University Hospital
Essen, Essen, Deutschland
3University of Cologne, Faculty of Medicine and University Hospital Cologne,
Department I of Internal Medicine, Köln, Deutschland
4FOM University of Applied Sciences, Essen, Deutschland
5University of Cologne, Faculty of Medicine and University Hospital Cologne,
Center for Inte-grated Oncology (CIO ABCD), Köln, Deutschland
Background: Sepsis accounts for over 20% of global mortality and is
associated with high in-hospital morbidity. Next-generation sequencing
(NGS) oers faster and more sensitive DNA analysis for sepsis identi-
cation compared to blood cultures, allowing targeted therapy. However,
evaluating the cost-eectiveness of innovative procedures is crucial due
to increasing healthcare expenses. is study aimed to analyze the budget
impact of NGS on inpatient costs from a payer perspective in Germany.
Methods: Real-world cost data from two hemato-oncology departments
(University Hospitals Cologne and Essen) were collected. Eligibility criteria
were oncologic main diagnosis, requested blood culture, and sepsis diag-
nosis. Based on Grumaz et al., cost savings were calculated by modeling a
length of stay (LOS) reduction of 8 days (general ward) and 4 days (intensive
care unit) for patients who were high outliers in LOS (1). We assumed an
NGS positivity rate of 71%. e analysis compared NGS procedure costs
(€1.499) with modeled cost savings from shortened LOS on a case basis.
Result: 208 cases were analyzed. Average cost savings amount to €2.272,39
(95% CI: 2.050,3-2.494,5). Further, a budget impact of €773,39 (551,3-
995,5) per case was identied for the entire study population.
Discussion: Our budget impact analysis showed that NGS resulted in
cost savings supporting decision-makers in implementing this innovative
approach in the German healthcare sector. With a comprehensive imple-
mentation, procedure costs are expected to decrease further.
Conclusion: NGS leads to cost savings, improved patient care, and con-
taining unnecessary treatments and their costs.
Indication of source:
1. Grumaz S, Grumaz C, Vainshtein Y, Stevens P, Glanz K, Decker SO,
et al. Enhanced Performance of Next-Generation Sequencing Diagnostics
Compared With Standard of Care Microbiological Diagnostics in Patients
Suering From Septic Shock. Crit Care Med. 2019;47(5):e394-e402.
Disclosure Statement: e authors declare the following: A-C Siefen, J Trümmler
and F Kron are employees of the VITIS Healthcare Group, which was sponsored
by Noscendo GmbH in connection with the development of the study. e
funder of the study had no role in study design, data collection, data analysis,
or data interpretation and writing of the abstract. F Jakobs received consulting
fees or honorarium for participation on an Advisory Board from Alexion, Cerus,
Noscendo, Novartis, Pzer, Seagen.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts110
558
Quantitative analysis of the impact of the nursing strike
2022 in NRW on oncological care at the Center for Integrated
Oncology (CIO)
Scarlett Berressem1; Anja Köchel2; Nicolas Sauerbrunn2; Michael
Neumann3; Katharina Lichius3; Christiane Döge3; Andreas Stutzki4;
Cornelia von Levetzow1
1CIO Cologne, University Hospital Cologne, Center for Integrated Oncology
Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Deutschland
2CIO Aachen, University Hospital Aachen, Center for Integrated Oncology
Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Deutschland
3CIO Bonn, University Hospital Bonn, Center for Integrated Oncology Aachen
Bonn Cologne Duesseldorf (CIO ABCD), Bonn, Deutschland
4CIO Duesseldorf, University Hospital Duesseldorf, Center for Integrated
Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Duesseldorf,
Deutschland
Background: In 2022 nursing sta of the university hospitals in NRW
went on strike for 79 days in May, June and July. During the strike,
numerous operations, diagnostic steps and therapies had to be cancelled
or postponed. e extent to which this also aected oncology patients
will be determined in an initial analysis based on controlling and cancer
registry data.
Methods: Dierent categories were dened to represent the quantitative
eects. A: number of tumorboard recommendations (TBs), B: number
of oncological surgical interventions (SI), C: number of inpatients with
chemotherapy (CTX), D: number of inpatients with radiotherapy (RTX).
Controlling and cancer registry data of CIO Cologne were used as data
basis. To increase the sample size, category B was expanded to include
data from the CIO sites Aachen, Bonn, Duesseldorf.
Result: ere was a 10-14% reduction of TBs during the strike, followed
by a 15% increase above annual mean (AM) in August. e overall annual
values signicantly exceeded the previous years values. In May the num-
ber of patients with SI in the CIO Aachen Bonn Cologne Düsseldorf was
36% below the AM, followed by an increase in SI of almost 20% in August
compared to the AM. In May and June, approximately 10% less patients
with planned CTX were admitted than the AM. Minimal reductions could
also be seen in patients with RTX in one month, June (4-11%).
Discussion: e number of SI patients in the four CIO sites during the
strike declined signicantly. e previous years numbers (2021: Covid
pandemic) could not be achieved over the course of the year. e num-
ber of TBs in CIO Cologne was reduced during the strike. Decreases in
the number of CTX and RTX inpatients were also observed, whereby
the impact on the RTX patients was lower. Nevertheless, the individual
areas (except for SI) achieved high overall annual values, demonstrating a
recovery during the year.
Conclusion: e strike had signicant quantitative eects, especially on
surgical interventions. Qualitative eects and long-term consequences
should be investigated in further studies focusing on patient follow up.
Disclosure Statement: e authors declare no conict of interest.
650
Trans-sectoral personalized care concept for patients with
rare cancer (TARGET): testing a new form of care
Vanessa Kratzer1; Hana Algül1,2; Birte Berger-Höger3; Michael von
Bergwelt-Baildon4; Volker Heinemann1,4; Ramona Gaube5;
Ursula Kronawitter6; Friederike Mumm1,4; Daniel Nasseh1;
Maximilian Reichert2; Sandra Riesch7; Oliver Schöski8; Anke Steckelberg9;
C. Benedikt Westphalen1,4; Martin Zünkeler10; Karin Berger4;
On Behalf of the Target-Study Group11
1Comprehensive Cancer Center Munich, Munich, Deutschland
2Department of Internal Medicine II, Technical University of Munich, School of
Medicine, University Hospital rechts der Isar, Munich, Deutschland
3Institute for Public Health and Nursing Research, University of Bremen,
Bremen, Deutschland
4Department of Medicine III, LMU University Hospital, LMU Munich, Munich,
Deutschland
5Association of Statutory Health Insurance Physicians in Bavaria, eHealth and
digital future Department of Health Care Innovations, Munich, Deutschland
6Association of Specialists in Haematology and Medical Oncology in Germany
e.V., Southern Bavaria, Traunstein, Deutschland
7AOK-Bayern-Die Gesundheitskasse, Division Supply Management Strategy and
Contracts Department, Munich, Deutschland
8Health Management, School of Business, Economics and Society, Friedrich-
Alexander University (FAU) Erlangen-Nürnberg, Nuremberg, Deutschland
9Institute of Health and Nursing Science, Medical Faculty of Martin Luther
University Halle-Wittenberg, Halle (Saale), Deutschland
10KAIROS GmbH, Bochum, Deutschland
11Munich, Deutschland
Background: In the case of rare cancers, interdisciplinary expertise and
optimized communication between patients and their treatment team are
essential to provide patient-centered care. e Trans-sectoral Personalised
Care Concept for Patients with Rare Cancers (TARGET), funded by the
innovation fund at the G-BA, aims to enhance trans-sectoral patient-cen-
tered care coordination in patients with rare cancers in South Bavaria.
Methods: Mixed methods design, enrolling patients with rare cancers
diagnosis, insured by AOK-Bayern. Interventional measures: structured
access to specialized rare cancer care (clinical contact person, CCC-
Munich), virtual tumor boards with participation of oce-based oncol-
ogists, an electronic case le to streamline trans-sectoral information
exchange, virtual psycho-oncology to bridge access to long-term local
care, Onco-Coach to provide coordinative support, and a patient app e.g.
chat with Onco-Coach, distress thermometer. Oce-based oncologist
have access to online and onsite shared decision making training, patients
have access to the decision support tool and decision coaching services.
e summative, formative and health economic evaluation will assess the
following endpoints: Coordination of care from the patients perspective
(CCI-D), progression-free survival, overall survival, treatment progres-
sion, time to diagnosis, patient-reported outcomes (EORTC QLQ-C30),
health literacy (FCCHL), and resource consumption. Control groups are
formed by observational study, patient survey, secondary data, and claims
data use.
Result: TARGET runs from 2022-2025: Preparation phase is completed,
control groups and intervention group (Enrollment: 03/2023-06/2024) are
running and data collection for evaluation is ongoing.
Discussion: Evaluation will show to what extent TARGET can optimize
Germany’s fragmented healthcare system.
Conclusion: It is expected that TARGET will improve care coordina-
tion, enhance quality of life, and lead to longer (overall/progression-free)
survival.
Disclosure Statement: e authors declare the following: e project on which
this publication is based was funded by the Innovation Committee of the Joint
Federal Committee under the funding code 01NVF20012.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 111
777
Economic inuences on medical decision-making in oncology:
a qualitative and quantitative approach
Julia König1; Birthe Aufenberg2; Sabine Sommerlatte3; Jan Schildmann3;
Wolfgang Greiner2; Eva Winkler1; Katja Mehlis1
1Klinik für Medizinische Onkologie, Nationales Centrum für Tumorerkrankungen
Heidelberg, Medizinische Fakultät Heidelberg, Universitätsklinik Heidelberg,
Heidelberg, Deutschland
2Gesundheitsökonomie und Gesundheitsmanagement, Fakultät für
Gesundheitswissenschaften, Universität Bielefeld, Bielefeld, Deutschland
3Institut für Geschichte und Ethik der Medizin, Martin-Luther-Universität
Halle-Wittenberg, Halle (Saale), Deutschland
Purpose: e possible inuence of economic factors on medical deci-
sion-making is widely discussed, but little is known about specic deci-
sion-making situations that are inuenced by economic factors in German
oncology and the extent to which they are impactful.
Methods: To identify situations inuenced by economic considerations,
15 qualitative semi-structured interviews were conducted with physi-
cians who had experience in controlling and budgeting in oncology,
audio-recorded, transcribed and evaluated by means of qualitative con-
tent analysis. Subsequently, medical decision-making situations in which
economic considerations had a substantial impact, were identied, cat-
egorized and, if possible, operationalized for identication in German
claims data. e prevalence of the operationalized situations was analyzed
exploratively. Depending on their type, further analyses were carried out.
Results: Several decisions regarding patient care that were strongly inu-
enced by economic considerations were identied. ese decisions con-
cerned (1) diagnostic procedures, (2) application form and (3) frequency
in systemic treatment and (4) application form and (5) frequency in
localized therapeutic interventions. Several factors were identied that
inuenced economic considerations: e.g. treatment price, infrastructure,
patients’ frailty, and clinical sector. Preliminary results of claims data anal-
ysis will be available at presentation.
Discussion: Economic inuences eect decision-making situations in
German oncology and present incentives that have the potential to reduce
quality of patient care and could lead to rationalization. However, eco-
nomic considerations also provide an important gate-keeping function to
ensure that resources are not spent unnecessarily.
Conclusions: Economic considerations are part of oncology and inu-
ence daily practice. erefore, awareness for economic inuences should
be raised in the oncological community and recommendations on how to
deal appropriately with economic inuences should be developed.
Disclosure Statement: e authors declare no conict of interest.
786
Access to healthcare, experiences with care coordination,
patients’ needs, and expectations: the rare cancer patients’
perspective
Laura Oestreich1; Myrto Boukovala1; Theres Fey2; Volker Heinemann3;
Jana Hinneburg4; Vanessa Kratzer2; Julia Lühnen5; Friederike Mumm3;
Theresia Pichler3; Anna Patricia Schön1; Anke Steckelberg4; Michael von
Bergwelt-Baildon1; C. Benedikt Westphalen3; Sandro Zacher4; Danmei
Zhang1; Karin Berger1; On Behalf of the Target-Study Group6
1Department of Medicine III, LMU University Hospital Munich, Munich,
Deutschland
2Comprehensive Cancer Center (CCC Munich LMU), LMU University Hospital
Munich, Munich, Deutschland
3Department of Medicine III and Comprehensive Cancer Center (CCC Munich
LMU), LMU University Hospital Munich, Munich, Deutschland
4Institute for Health and Nursing Science, Interdisciplinary Centre for Health
Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle
(Saale), Deutschland
5Institute of Clinical Nursing Science, Charité – Universitätsmedizin Berlin,
corporate member of Freie Universität Berlin and Humboldt Universität zu
Berlin, Berlin, Deutschland
6Munich, Deutschland
Background: Patients with rare cancers oen face challenges, such as
delays in diagnosis, limited access to specialized care, and coordination
hurdles among multiple healthcare providers. In Germany, evidence on
these aspects and patients’ needs is scarce. In the context of the G-BA
Innovation Fund project “Trans-sectoral personalized care concept for
patients with rare cancers (TARGET)”, we aim to explore the patients
perspective.
Methods: is observational study is based on an online survey includ-
ing patients with a rare cancer diagnosis. e questionnaire is based
on explorative, semi-structured interviews (CCC LMU), and pilot-
tested. e survey includes the Care Coordination Instrument (CCI)1.
Distribution channels are CCC Munich departments, outpatient prac-
tices, and Bavarian cancer support groups.
Result: e study will continue until the end of 2023. In the interviews,
patients reported challenges regarding referrals to specialist centers, insuf-
cient guidance for supportive care, and lack information on potential
access to clinical studies, wishing for broader information for these top-
ics. e survey results on access to healthcare (e.g. access to specialists/
supportive care, time interval from rst symptoms to diagnosis), care
coordination from patients’ perspective (CCI), health literacy, patient sat-
isfaction and expectations will be stratied, e.g. by dierences between age
groups and geographical regions.
Discussion: e survey will lead to a better understanding on patients
perspectives, routes to diagnosis/treatment, experiences and needs of
patients with rare cancer. Further, the results will serve as a control group
for the evaluation of the care concept TARGET.
Conclusion: e generated information will provide valuable insights
for discussions on optimizing healthcare structures to ensure future
patient-centered rare cancer care.
Indication of source:
1 Okado, I. et al. “Development and psychometric evaluation of a questionnaire
to measure cancer patients’ perception of care coordination. BMC Health Serv
Res, 2020. 20(1): 52.
Disclosure Statement: e authors declare the following: e project on which
this publication is based was funded by the Innovation Committee of the Joint
Federal Committee under the funding code 01NVF20012.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts112
Hematooncology including Bone marrow
transplantation, Lymphoma, Plasmocytoma
76
Non-myeloablative (NMA) allogeneic hematopoietic stem cell
transplantation (alloHSCT) for elderly and comorbid patients
(pts) with acute lymphoblastic leukemia (ALL)
David Beverungen1; Heiko Trautmann2; Theresa Tumewu1; Madlen
Jentzsch1; Sebastian Schwind1; Georg-Nikolaus Franke1; Dietger
Niederwieser1; Monika Brüggemann2; Marco Herling1; Uwe Platzbecker1;
Vladan Vucinic1
1Universitätsklinikum Leipzig, Medizinische Klinik I, Klinik und Poliklinik für
Hämatologie, Zelltherapie, Hämostaseologie und Infektiologie, Leipzig,
Deutschland
2Universitätsklinikum Schleswig-Holstein, Hämatologie Labor Kiel, Sektion für
hämatologische Spezialdiagnostik, Kiel, Deutschland
Background: AlloHSCT is a potentially curative option for pts with high-
risk or relapsed & refractory (r/r) standard-risk ALL. e conventional
myeloablative or reduced intensity regimens cannot be applied to comor-
bid and elderly pts, rendering NMA conditioning for this cohort the only
available mode of alloHSCT.
Methods: We analyzed 28 pts (median age at alloHSCT 60 [range 23-71]
years undergoing alloHSCT aer NMA conditioning between 2004 and
2018. 18 pts were in rst complete remission (CR), nine in CR2, and one
was not in remission. Nine pts were Philadelphia Chromosome positive
(Ph+). Measurable residual disease (MRD) was available for 22 pts of
which 13 were MRDpos before alloHSCT. MRD in Ph+ pts was assessed by
polymerase chain reaction (PCR) for BCR::ABL1 gene in Ph+, and with
immunoglobulin/T-cell receptor rearrangement in Ph-. e median fol-
low-up aer alloHSCT was 3084 (166-5694) days.
Result: Progression-free survival (PFS) and overall survival (OS) for all
pts were 291.5 (6-5694) and 984 (6-5694) days, respectively. Aer one
year, cumulative relapse incidence and non-relapse mortality (NRM)
were 17.8% and 35.7%, respectively. Ph+ pts showed superior median OS
with 1260 (352-5286) and 300 (6-5694) days (p=0.04), but no dierences
in median PFS with 192 (6-5694) and 1002 (75-4384) days, respectively
(p=0.23). We detected no dierences regarding OS and PFS regarding
MRD status (p=0.88). Factors like sex (p=0.40), age (p=0.13), GvHD
(p=0.31) did not show signicant inuence on outcomes aer alloHSCT.
Discussion and Conclusion: We demonstrate that NMA alloHSCT is a fea-
sible option for comorbid and elderly pts with ALL, emphasizing the role
of gra-vs-leukemia eect, although showing considerable NRM. We did
not observe the negative prognostic role of MRDpos, probably to the limited
number of patients. Our analysis shows encouraging OS of Ph+ pts.
Disclosure Statement: e authors declare no conict of interest.
121
Development of a Modular Patient-Reported Outcomes Tool
on Patient Needs and Benets in CLL (PBI-CLL)
Beke Hester1; Helen Beckmann2; Julia von Tresckow3; Minna Voigtlaender1;
Manfred Welslau4; Christine Blome1
1Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
2AstraZeneca GmbH, Hamburg, Deutschland
3Universitätsklinikum Essen, Essen, Deutschland
4MVZ am Klinikum Aschaenburg, Aschaenburg, Deutschland
Background: Chronic lymphocytic leukemia (CLL) is the most common
form of leukemia in adults in western countries. Numerous new treatment
options underline the importance of considering individual patient needs in
treatment decision making. To date, no instrument exists to capture these
needs. is project aims to develop an electronic Patient-Reported Outcome
Measure (ePROM) that assesses treatment goals and benets in CLL.
Methods: e ePROM will be developed based on the Patient Benet
Index (PBI) methodology which captures importance and achievement of
treatment goals. e PBI-CLL will introduce three modules on treatment
preferences: general preferences, process quality, and therapy outcomes.
Qualitative interviews with an anticipated n=30 participants will be con-
ducted to capture treatment goals and disease burden in CLL; in addition,
free-text questionnaires will be completed. Based on qualitative content anal-
ysis according to Kuckartz, a dra version of the PBI-CLL will be developed
in an expert panel and will be adapted aer cognitive debrieng interviews.
Result: To date, 28 interviews have been conducted; we expect comple-
tion of data collection and analysis by the end of 2023. Preliminary results
show that the individual burden of CLL varies widely; some patients
reported high, others low impact on their mental health. Patients reported
dierent treatment goals, for example preferences in the administration
method and site. Patients also wished for empathic hematologists who
provide them with ample information about their disease and the treat-
ment options. Overall, CLL patients wanted a treatment that allows them
to live normally with few limitations through their disease or treatment.
Discussion: e preliminary results show that burdens and treatment
goals in CLL vary considerably between patients which underlines the
heterogeneity of this patient group.
Conclusion: e ndings conrm the importance of a new instrument
measuring treatment goals and benets in a standardized way which can
be utilized in both routine care and clinical studies.
Disclosure Statement: e authors declare the following: this study is conducted
in cooperation with and funded by AstraZeneca.
186
Gene Expression Clusters in the JAK-STAT Pathway in
Adolescent and Young Adults (AYA) and Non-AYA Patients
with BCR::ABL Negative Myeloproliferative Neoplasm (MPN)
– Results of MAry, a multicenter project of the East German
Study Group for Hematology and Oncology (OSHO)
Alice Diepers1; Susann Schulze1,2; Nadja Jäkel3; Danny Misiak4; Christina
Zahn3; Claudia Spohn5; Regina Moeller5; Dietrich Kämpfe6; Maik Schwarz7;
Katrin Nerger8; Bayram Edemir8; Haifa Al-Ali1
1Krukenberg Cancer Center Halle, University Medicine Halle, Halle (Saale),
Deutschland
2Carl-von-Basedow-Klinikum Saalekreis, Department of Medicine Clinic II, Halle
(Saale), Deutschland
3University Clinic and Outpatient Clinic for Internal Medicine IV, University
Hospital Halle, Halle (Saale), Deutschland
4Institute of Molecular Medicine, University Medicine Halle, Halle (Saale),
Deutschland
5Hämatologisch-Onkologische Gemeinschaftspraxis, Halle (Saale), Deutschland
6Praxis für Hämatologie und Onkologie, Lüdenscheid, Deutschland
7Paracelsus Medizinisches Versorgungszentrum, Schwerpunktpraxis für
Hämatologie und Onkologie, Schoeneck, Deutschland
8University Clinic and Outpatient Clinic for Internal Medicine IV, Medical Faculty
of the Martin Luther University Halle-Wittenberg, Halle (Saale), Deutschland
Background: Phenotype driver mutations (mut) and JAK-STAT dys-
regulation characterize MPN. We studied the expression (Exp) of JAK2,
CALR, STATs in AYAs (<39 y. at diagnosis) and Non-AYA patients (pts)
with BCR::ABL negative (neg) MPN within the Incyte Biosciences funded
MAry project, approved by ethical committees.
Methods: Aer signed informed consent, phenotype data and blood sam-
ples were collected [AYA=45, Non-AYA=77]. Besides whole transcriptome
sequencing (RNA-seq) from blood derived RNA, WES from blood and FACS
sorted CD3+ cells derived DNA was performed. e bioinformatic analyses
were done at the Core Facility Imaging of the MLU Halle-Wittenberg. Merging
of variant and annotation data was performed via an in-house R script.
Results: Median ages of AYAs and Non-AYAs were 33 and 52 y. respectively.
Male/female ratio and MPN duration were comparable. Diagnoses were ET
(44%), PV (27%), PMF (23%), and unclassied MPN (6%). JAK2V617F,
CALR, and MPL mut were detected in 77%, 11%, and 1.7%. 11 (9%) pts
were triple neg. Irrespective of phenotype driver mut or diagnosis, CALR
Exp was neg associated (assoc) to JAK2 Exp (R²=0.3) and was signicantly
higher (p<0.000). In linear regression models, STAT1 Exp was positively
(pos) assoc with STAT2 (R²=6) and STAT3 (R²=0.3). JAK2V617F and CALR
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 113
mut correlated with higher JAK2 and CALR Exp respectively (p=0.02) but
not with STATs Exp. JAK2 Exp was pos assoc with STAT5B and STAT6 Exp
(R²=0.6;p<0.000) and neg related to STAT4 Exp (R²=0.4;p<0.000). CALR
Exp was neg assoc to STAT5B and STAT6 Exp (R²=0.5;p<0.000). In AYAs a
lower JAK2 (p<0.000), STAT5B (p=0.003), and STAT6 (p=0.006) Exp and a
higher CALR (p=0.05) and STAT4 (p<0.000) Exp cluster was seen. A higher
JAK2/STAT5B/STAT6 and a lower STAT4 Exp cluster was signicantly
assoc with thrombotic events and MPN therapy.
Conclusions: Distinct gene Exp clusters in the JAK-STAT pathway are
assoc with certain phenotypic features. Exp quantitative trait locus analy-
ses within MAry will evaluate the association between Exp levels and the
genotype at a SNV locus to provide evidence for a SNV’s regulatory role.
Disclosure Statement: e authors declare the following: HKA-A: Research
support from Novartis, Bristol Myers Squibb and Incyte, Participating on a
scientic advisory board for Novartis, Bristol Myers Squibb, Abbvie, SGK, Blue
Print, AOP Pharma; Travel grant from Novartis, Bristol Myers Squibb and Abbvie;
MS: Travel grant from Janssen, Servier, AstraZeneca
260
Cumulative Review of Hypertension (HTN) in Patients With
Chronic Lymphocytic Leukemia (CLL) and Other Hematologic
Malignancies Treated With Acalabrutinib
Stephan Stilgenbauer1; Alessandra Ferrajoli2; George Follows3; Yotvat
Marmor4; Shogheeg Apkarian Bourjlian5; Jack Roos5; Naghmana Bajwa5;
Venkata Madhira6; Kenji Nozaki7; Paulo Miranda5; Krish Patel8
1University of Ulm, Ulm, Deutschland
2University of Texas MD Anderson Cancer Center, Houston, USA
3Addenbrookes Hospital, Cambridge, United Kingdom
4AstraZeneca, South San Francisco, USA
5AstraZeneca, Gaithersburg, USA
6AstraZeneca, Wilmington, USA
7AstraZeneca, Osaka, Japan
8Swedish Cancer Institute, Seattle, USA
Background: Here, we performed a cumulative analysis of new or wors-
ening HTN from the acalabrutinib (A) global development program and
compared these data against reported prevalence and incidence of HTN
for pts with CLL in real-world and clinical trials.
Methods: Safety reports of new or worsening HTN were obtained from 11
clinical trials with A monotherapy (mono). or in combination with obinu-
tuzumab (O)) and active comparators. Using the Standardized MedDRA
Query and the related MedDRA preferred terms for “HTN,” exposure-ad-
justed incidence rates (EAIRs) in events/100 person-years were determined,
and HTN prevalence was assessed at median treatment exposure for A
mono. HTN prevalence was also assessed from 3 closed claims databases.
Result: e prevalence of HTN ranged from 47.3% to 66.1% in pts with TN
CLL prior to treatment initiation. HTN prevalence with A mono at 45.5
months (mos) of exposure was 55.7%. EAIRs of HTN were analyzed from
11 clinical trials; 1225 pts received A mono (947with CLL), 223 pts A + O
(all with CLL), 264 pts ibrutinib (I) as a comparator (all with CLL), and 322
pts other comparators (all with CLL). Among the 1225 pts treated with A
mono, 165 pts (147 with CLL) had treatment emergent HTN (59.4% [n=98]
with history of HTN at baseline). e EAIRs of HTN with A mono (3.844)
and A + O (3.926) were similar to that of other comparators (4.788 [exclud-
ing ibrutinib]). In ELEVATE-RR study specically, the EAIR of HTN with
A (3.053) was approximately one-third that of I (8.590). EAIR of HTN in pts
treated with A mono without history of HTN was 3.239.
Discussion: HTN is a common comorbidity in CLL pts as demonstrated
in claims database and clinical trial database analyses. Incidence rates of
new or worsening HTN with A mono and A + O were low. is is sup-
ported by similar incidence proportion of new or worsening HTN in pts
receiving placebo (8.3%) from CLL12 (median follow-up 69.3 mos) and A
mono (8.9%) from ELEVATE-TN (median follow-up 58.2 mos).
Conclusion: Our analysis suggests that A mono did not worsen pre-exist-
ing HTN or increase the risk of new-onset HTN.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
278
Acalabrutinib ± Obinutuzumab (A, A+O) vs Obinutuzumab
+ Chlorambucil (O+Clb) in Treatment-Naive Chronic
Lymphocytic Leukemia: 6-Year Follow-Up of ELEVATE-TN
Uwe M. Martens1, Je Sharman2, Miklos Egyed3, Wojciech Jurczak4, Alan
Skarbnik5, Krish Patel6, Ian W Flinn7, Manali Kamdar8, Talha Munir9,
Renata Walewska10, Marie Hughes11, Laura Maria Fogliatto12, Yair
Herishanu13, Versha Banerji14, George Follows15, Patricia Walker16, Karin
Karlsson17, Paolo Ghia18, Ann Janssens19, Florence Cymbalista20, John C.
Byrd21, Emmanuelle Ferrant22, Alessandra Ferrajoli23, William G. Wierda23,
Jennifer A. Woyach21
1Clinic for Hematology, Oncology and Palliative Care, SLK Kliniken Heilbronn,
Heilbronn, Deutschland
2Willamette Valley Cancer Institute and Research Center/US Oncology Research,
Eugene, USA
3Somogy County Mór Kaposi General Hospital, Kaposvár, Ungarn
4Maria Skłodowska-Curie National Research Institute of Oncology, Krakau, Polen
5Novant Health Cancer Institute, Charlotte, USA
6Swedish Medical Center, Seattle, USA
7Sarah Cannon Research Institute, Nashville, USA
8University of Colorado Cancer Center, Aurora, USA
9Haematology, Haematological Malignancy Diagnostic Service (HMDS), St.
James’s Institute of Oncology, Leeds, United Kingdom
10Cancer Care, University Hospitals Dorset, Bournemouth, United Kingdom
11Tauranga Hospital, Tauranga, Neuseeland
12Hospital de Clinicas de Porto Alegre, Porto Alegre, Brasilien
13Tel Aviv Sourasky Medical Center - Ichilov, Tel Aviv-Yafo, Israel
14Departments of Internal Medicine, Biochemistry & Medical Genetics, Max Rady
College of Medicine, Rady Faculty of Health Sciences, University of Manitoba
and CancerCare Manitoba, Winnipeg, Kanada
15Department of Haematology, Addenbrooke’s Hospital NHS Trust, Cambridge,
United Kingdom
16Peninsula Health and Peninsula Private Hospital, Frankston, Langwarrin,
Australien
17Skåne University Hospital Lund, Lund, Schweden
18Università Vita-Salute San Raaele and IRCCS Ospedale San Raaele, Milano,
Italien
19University Hospitals, Leuven, Belgien
20Bobigny: Hématologie, CHU Avicennes, Bobigny, France, Bobigny, Frankreich
21The Ohio State University Comprehensive Cancer Center, Columbus, USA
22Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d’Hématologie
Clinique, Pierre-Bénite, Frankreich
23University of Texas MD Anderson Cancer Center, Houston, USA
Background: Herein, we report updated results at 74.5 mo of follow-up of
the ELEVATE-TN trial.
Methods: Pts were randomized to A+O, A, or O+Clb. Pts with progres-
sion on O+Clb could cross over to A mono. Investigator-assessed (INV)
progression-free survival (PFS), INV overall response rate, overall sur-
vival (OS), and safety were evaluated.
Result: A total of 535 pts (A, n=179; A+O, n=179; O+Clb, n=177) had a
median age of 70 y, 63% had unmutated IGHV (uIGHV), and 14% had
del(17p) and/or TP53 mutation (TP53m). At a mFU of 74.5 mo (data cut-
o MAR 3, 2023), median PFS (mPFS) was not reached (NR) for A+O
and A vs 27.8 mo for O+Clb (hazard ratio [HR] vs O+Clb: 0.14 and 0.23,
respectively; P<0.0001 for both; HR A+O vs A: 0.58; P=0.0229). Median
OS (mOS) was NR in any arm and was signicantly longer with A+O
vs O+Clb (HR: 0.62; P=0.0349). In 337 pts with uIGHV, mPFS was NR
for A+O and A vs 22.2 mo for O+Clb (HR: 0.08 and 0.12, respectively;
P<0.0001 both). In 73 pts with del(17p) and/or TP53m, mPFS was 73.1
mo for A+O and NR for A vs 17.5 mo for O+Clb (HR: 0.28 and 0.23,
respectively; P≤0.0009 both). mOS was NR for A+O and A vs 74.9 mo for
O+Clb (HR: 0.53 and 0.46, respectively, neither statistically signicant).
Adverse events (AEs) for O+Clb have been previously reported. Most
common (≥5%) gr. ≥3 AEs for A+O and A, respectively, were neutrope-
nia (31%/12%), thrombocytopenia (8%/3%), diarrhea (6%/1%), COV-
19 (9%/7%), pneumonia (7%/6%), syncope (5%/ 2%), and hypertension
(HTN) (4%/5%). For events of clinical interest, gr. ≥3 atrial brillation,
HTN, and secondary primary malignances were reported in 2%, 4%, and
10% with A+O and 2%, 5%, and 5% with A, respectively. e most com-
mon reasons for treatment discontinuation were AEs, in 21% (n=38) with
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts114
A+O and 18% (n=32) with A, and progressive disease, in 6% (n=10) with
A+O and 14% (n=25) with A.
Discussion: With mFU of 74.5 mo, the ecacy and safety of A+O and A
mono were maintained in pts with TN CLL, including in pts with high-
risk genetics.
Conclusion: At 6 years of FU, PFS was signicantly longer with A+O vs
A. mOS was NR in any study arm and was signicantly longer with A+O
vs O+Clb.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
308
Multiple Myeloma Registry of the East German Study Group
Hematology/Oncology (OSHO): updated analysis of rst and
second lines' treatment results
Sebastian Böttcher1; Brigitte Kragl1; Maximillian Merz2; Gabriele
Prange-Krex3; Martin Schmidt-Hieber4; Harald Schmalenberg5; Lars-Olof
Muegge6; Christoph Kimmich7; Anke Gerhardt8; Christian Scholz9;
Beate Krammer-Steiner10; Andreas Schwarzer11; Dietrich Kämpfe12;
Franziska Brunner13; Ulrike Triegla14; Christoph Kahl15; Inessa Paulenz16;
Philipp Kiewe17; Philipp Hemmati18; Mathias Hänel19; Detlev Hähling20;
Malte Leithäuser21; Susann Schulze22; Ulrich Ingo Langenkamp1;
Christian Junghanß1
1Universitätsmedizin Rostock, Zentrum für Innere Medizin, Medizinische Klinik
III - Hämatologie, Onkologie, Palliativmedizin, Rostock, Deutschland
2Uniklinikum Leipzig, Klinik und Poliklinik für Hämatologie, Leipzig, Deutschland
3Gemeinschaftspraxis für Hämatologie und Onkologie, Dresden, Deutschland
4Carl-Thiem-Klinikum, 2. Medizinische Klinik, Hämatologie/Onkologie, Cottbus,
Deutschland
5Städtisches Klinikum Dresden, IV. Med. Klinik - Hämatologie, Dresden,
Deutschland
6Heinrich-Braun-Klinikum, Innere Med. III – Zwickau, Deutschland
7Klinikum Oldenburg AöR, Universitätsklinik für Innere Medizin - Onkologie und
Hämatologie, Oldenburg, Deutschland
8Schwerpunktpraxis für Hämatologie und Onkologie Dr. A. Gerhardt, Dr. H.
Linde, B.Matthes, Potsdam, Deutschland
9Vivantes, Klinikum am Urban, Innere Medizin - Hämatologie und Onkologie,
Berlin, Deutschland
10Klinik für Hämatologie,Onkologie,Hämostaseologie, Komplementär-und
Palliativmedizin, Rostock, Deutschland
11Onkopraxis Probstheida, Leipzig, Deutschland
12Praxis für Hämatologie und Onkologie, Lüdenscheid, Deutschland
13Klinik für Innere Medizin IV Onkologie/Hämatologie Universitätsklinikum
Halle/Saale, Halle/Saale, Deutschland
14Gemeinschaftspraxis Dr. Gröpler/Triegla, Wismar, Deutschland
15Klinikum Magdeburg gGmbH, Klinik für Hämatologie/Onkologie, Magdeburg,
Deutschland
16Städtisches Klinikum Dessau, Klinik für Innere Medizin - Hämatologie/
Onkologie, Dessau, Deutschland
17MVZ Onkologischer Schwerpunkt am Oskar-Helene-Heim, Berlin, Deutschland
18Dietrich-Bonhoeer-Klinikum Neubrandenburg, Klinik für Hämatologie,
Onkologie und Immunologie, Neubrandenburg, Deutschland
19Klinikum Chemnitz gGmbH, Innere Medizin III, Hämatologie / Onkologie /
Stammzelltransplantation, Chemnitz, Deutschland
20Schwerpunktpraxis Onkologie / Hämatologie, Schwerin, Deutschland
21Gemeinschaftspraxis für Onkologie, Rostock, Deutschland
22Carl-von-Basedow Klinikum Saalekreis gGmbH, Zentrum für Innere Medizin,
Medizinische Klinik III, Merseburg, Deutschland
Background: Modern therapies in multiple myeloma (MM) have been
licensed based on prospective trials, which might not fully reect daily
treatment practice. e OSHO MM registry (OSHO trial #89) aims to
investigate patients (pts) in real world settings (focus: ecacy, safety,
treatment sequences, and MRD).
Methods: As of August 1, 2023, 805 pts from 28 centers were included.
Le over samples could be assessed for MRD using next generation ow
cytometry with a sensitivity of 10-5 at a central laboratory.
Result: Most pts (median age 70 years (range, 37-90)) presented with
IgG MM (58%), followed by light chain MM (21%), IgA MM (20%) and
non-secretory MM (1%). 21% of all pts carried high risk cytogenetic
aberrations (del17p, t(4;14), t(14;16)) whereas ampl 1q21 was observed in
28%, t(11;14) in 18%, and hyperdiploidy in 27%. PFS and OS analyses were
restricted to 299 pts with a prospectively documented minimum follow up
of 6 months (mos) on rst (1L, n=234) or second (2L, n=101) line treat-
ments (median follow up 11 mos). Out of 234 1L pts, 76 pts received an
autologous stem cell transplantation (SCT). A median PFS of 46 mos was
observed in pts treated with SCT whereas 158 pts who received therapies
without SCT experienced a shorter PFS (26 mos, p<0.001). Accordingly,
OS diered signicantly (NR vs 35 mos, p < 0.0001). Transplant eligible pts
were younger than transplant ineligible pts (63 vs 77 years). In pts treated
without SCT, 40 received an induction based on a proteasome inhibitor
(PI), whereas an additional 35 pts were treated with PI-antibody com-
binations (mPFS 19 vs 22 mos, ns). PFS was similar in pts who received
an IMID based 1L treatment irrespective of the addition of an antibody
(10 vs 59 pts, 26 mos vs NR, ns). Prospectively documented 2L treatment
from 101 pts resulted in a median PFS of 26 mos.
Discussion: Due to still limited follow up these preliminary real world
data should be interpreted with caution. Updated data will be presented
at the conference.
Conclusion: OSHO MM registry analysis corroborates the role for SCT
in the 1L treatment of multiple myeloma in the era of targeted therapies.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
315
Novel Telmisartan derivatives as add-on agents to circumvent
Imatinib resistance in CML
Maximilian Gebhart1; Stefan Salcher2; Ronald Gust1
1Universität Innsbruck - Campus Innrain, Innsbruck, Österreich
2Medizinische Universität Innsbruck, Innsbruck, Österreich
Background: Chronic myeloid leukemia (CML) is a myeloprolifera-
tive disease caused by the mutation and proliferation of a monoclonal
multipotent hematopoietic progenitor cells. Resulting gene products
show a dysregulated tyrosine kinase activity [1]. Nowadays, targeted ther-
apy of CML with tyrosine kinase inhibitors (TKIs) is available. However,
TKIs frequently fail to completely eradicate the disease since quiescent
leukemic stem cells (LSCs) are highly insensitive to therapy. erefore,
the disease persists in a signicant number of patients. Previous studies
by our group indicated that TKI-resistant LCSs can be eciently targeted
by a combination therapy of Imatinib and the angiotensin 2 antagonist
Telmisartan [2,3]. Based on these promising ndings, we aimed to opti-
mize the chemical structure of Telmisartan.
Methods: To evaluate the activity and selectivity of the developed com-
pounds we performed a modied MTT assay with wild type K562
CML cells and their respective imatinib resistant subclone K562-R.
Furthermore, the mode of action was investigated by ow cytometry and
immunoassays. We also performed ADME studies to analyze the pharma-
cokinetic properties of the new compounds.
Result: With the new compounds, we could increase the cytotoxic activ-
ity of Imatinib on resistant CML cells from 10% to >90%. In addition,
the compounds are per se non-cytotoxic on non-malignant cell lines. We
could discover a unique mode of action while also partially retaining the
pharmacokinetic properties of Telmisartan.
Discussion: With the structural modications we could increase the activity
10-fold compared to Telmisartan while retain their selectivity. e ADME
studies showed that still some structural improvements can be made.
Conclusion: We obtained a better understanding of the pharmacokinetic
and pharmacodynamic properties of the novel compounds which pro-
vides the basis for future in vivo studies.
Indication of source:
[1] Soetzer O J et al, Dtsch Med Wochensch 2002; 127:2618–2620.
[2] Prost S et al, Nature 2015; 525(7569); 380–383.
[3] Schöpf A et al, Med Chem 185(2020) 111748.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 115
318
Quality of Life with Nivolumab and AVD First-Line Treatment
in Hodgkin Lymphoma: Patient-Reported Outcomes from the
Phase II GHSG NIVAHL Trial
Paul J. Bröckelmann1; Ina Bühnen1; Peter Herhaus2; Julia Meissner3; Karolin
Trautmann4; Horst Müller1; Michael Fuchs1; Bastian von Tresckow5; Peter
Borchmann1; Andreas Engert1; Karolin Behringer1
1Uniklinik Köln, Klinik I für Innere Medizin, Deutsche Hodgkin Studiengruppe
(GHSG), Köln, Deutschland
2Klinikum Rechts der Isar, Technische Universität München, Innere Medizin III,
München, Deutschland
3Uniklinik Heidelberg, Medizin V, Heidelberg, Deutschland
4Uniklinik Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden,
Deutschland
5Uniklinik Essen, Klinik für Hämatologie und Stammzelltransplantation,
Deutsche Hodgkin Studiengruppe (GHSG), Essen, Deutschland
Background: First-line treatment with nivolumab (N) in combination
with AVD chemotherapy is highly eective in Hodgkin lymphoma (HL).
Herein, we present the preplanned analysis of quality of life (QoL), fatigue
and life situation of the randomized GHSG phase II NIVAHL trial.
Methods: NIVAHL enrolled 109 patients with early-stage unfavorable
HL to receive either fully concomitant (4xN-AVD; group A) or sequen-
tial (4xN, 2xN-AVD, 2xAVD; group B) 1st-line treatment, each followed
by 30Gy IS-RT (Bröckelmann JCO 2023). Patients reported QoL and
fatigue by the EORTC QLQC30 questionnaire in addition to key socio-
demographic data. Data were analyzed descriptively and time-to-recov-
ery (TTR) calculated for resolution of fatigue (TTR-F) and return to work
(TTR-W).
Results: In a total of 99 evaluable patients, mean fatigue score was 22
points higher (95%CI 16.1-27.9) than the age- and sex-matched German
reference population at baseline, worsened during treatment (+38.2,
95%CI 31.4-44.9) but improved to normal values at 3-year FU (-3.4,
95%CI -10.7 to 3.9). Similar trajectories were observed for global health
status/QoL as well as the dierent functional and symptom scales. While
improvement beyond baseline (79.6, 95%CI 76.5-82.7, out of a max. score
of 100) was observed, global health status/QoL did not improve to age-
and sex-matched reference values at 1- (87.2, 95%CI 83.2-91.2) and 3-year
FU (92, 95%CI 87.8-96.2). Multiple regression analysis showed a signi-
cant eect of baseline score (ß 0.28-0.56) and age (ß 0.23-0.34) on cog-
nitive, emotional and social functional scales as well as fatigue at 1-year
of FU. Median TTR-F and TTR-W were 12.8 (95%CI 7.3-20.3) and 3.8
months (95%CI 1.4-8.0) aer EOT, respectively.
Discussion: is is the rst ever analysis of patient-reported outcomes
aer anti-PD1 based rst-line HL treatment.
Conclusion: Substantial fatigue and impaired global QoL status existing
at baseline relevantly improve aer nivolumab-based 1st-line treatment.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
335
Mezigdomide (MEZI) plus dexamethasone (DEX) and
bortezomib (BORT) or carlzomib (CFZ) in patients (pts) with
relapsed/refractory multiple myeloma (RRMM): results from
the CC-92480-MM-002 trial
Marc S Raab1; Albert Oriol2; Irwindeep Sandhu3; Darrell White4;
Richard Leblanc5; Noopur Raje6; Enrique M. Ocio7; Aurore Perrot8;
Thierry Facon9; Cesar Rodriguez10; Ralph Wäsch11; Michael Amatangelo12;
Zehua Zhou12; Yue Wang12; Tiziana Civardi13; Phillip Koo12; Paulo Maciag12;
Daniell Zhu12; Jessica Katz12; Paul G. Richardson14
1Universitätsklinikum Heidelberg, Heidelberg, Deutschland
2Catalan Institute of Oncology and Josep Carreras Institute, Hospital Germans
Trias i Pujol, Badalona, Spanien
3University of Alberta, Edmonton, Kanada
4Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax,
Canada
5Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Canada
6Massachusetts General Hospital, Boston, USA
7Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spanien
8Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, Frankreich
9Centre Hospitalier Universitaire (CHU) Lille, Service des Maladies du Sang,
University of Lille, Lille, Frankreich
10Icahn School of Medicine at Mount Sinai, New York, USA
11Department of Medicine, University of Freiburg Medical Center, Freiburg,
Deutschland
12Bristol Myers Squibb, Princeton, USA
13Celgene International Sàrl, a Bristol-Myers Squibb Company, Boudry, Schweiz
14Dana-Farber Cancer Institute, Boston, USA
Background: In the CC-92480-MM-002 trial (NCT03989414), MEZI had
promising ecacy and safety with DEX + BORT (MeziVd) and DEX +
CFZ (MeziKd) in RRMM pts. In phase 1, a 1.0mg dose + Vd (MeziVd-
1.0mg) was selected for further investigation. Here we report updated
results from the MeziVd and MeziKd dose-escalation cohorts and the
MeziVd-1.0mg dose-expansion cohort.
Methods: Eligible pts had: RRMM, 2–4 (MeziVd and MeziKd cohorts) or
1–3 (MeziVd-1.0mg cohort) prior regimens including lenalidomide, and
progressive disease during or aer last myeloma therapy. MEZI was given
at escalating doses (0.3, 0.6, 1.0mg) or at 1.0mg on days (D)1–14 of each
21-D cycle with Vd, or at escalating doses on D1–21 of each 28-D cycle
with Kd. Primary objectives were to determine the recommended dose
and regimen and to evaluate safety and ecacy.
Result: As of March 20, 2023, 28 pts received MeziVd, 38 MeziVd-1.0mg,
and 27 MeziKd. Across all cohorts, 65.8–88.9% pts were IMiD® agent
refractory, 18.4–51.9% pts were proteasome inhibitor (PI) refractory,
and 36.8–74.1% pts were anti-CD38 monoclonal antibody refractory;
median follow-up was 10.8–13.2 mo. e most frequent grade 3‒4 treat-
ment-emergent adverse events were neutropenia (35.7%) and thrombocy-
topenia (21.4%) with MeziVd; neutropenia (57.9%) and infections (34.2%)
with MeziVd-1.0mg; and neutropenia (40.7%) and infections (29.6%)
with MeziKd. Overall response rate was 75.0% with MeziVd; 84.2% with
MeziVd-1.0mg; and 85.2% with MeziKd. Median duration of response
was 10.4 and 11.9 mo in the MeziVd and MeziKd cohorts (MeziVd-1.0mg
cohort: not reached). MEZI had pharmacodynamic activity with BORT/
CFZ at all doses tested, with 1.0mg inducing the greatest substrate degra-
dation and T cell proliferation.
Discussion: With longer follow-up, MeziVd and MeziKd continued to
show promising ecacy with a manageable safety prole in RRMM pts.
Conclusion: Dose optimization of MEZI + DEX in combination with PIs
continues to be explored; these data support further exploration in phase
3 studies.
Prev. presented
First published: Oriol A et al. CLML 2023;23[suppl]:OA-49.
Disclosure Statement: e authors declare that there are conicts of interest.
econicts were submitted to the congress organizer KUKM GmbH and KUKM
can disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts116
336
Luspatercept versus epoetin alfa (EA) for treatment (tx) of
anemia in ESA-naive lower-risk myelodysplastic syndromes
(LR-MDS) patients (pts) requiring RBC transfusions (RBCT):
data from the phase 3 COMMANDS study
Uwe Platzbecker1; Matteo Giovanni Porta2,3; Valeria Santini4; Amer M.
Zeidan5; Pierre Fenaux6; Rami S. Komrokji7; Jake Shortt8; David Valcárcel9;
Anna Jonášová10; Sophie Dimicoli-Salazar11; Ing Soo Tiong12; Chien-Chin
Lin13; Jiahui LI14; Jennie Zhang14; Ana Carolina Giuseppi14; Sandra Kreitz15;
Veronika Pozharskaya14; Karen L. Keeperman14; Shelonitda Rose14; Jeevan
K. Shetty15; Sheida Hayati14; Sadanand Vodala14; Andrius Degulys16,17;
Stefania Paolini18; Thomas Cluzeau19; Guillermo Garcia-Manero20
1Medical Clinic and Policlinic 1, Hematology and Cellular Therapy, University
Hospital Leipzig, Leipzig, Deutschland
2Cancer Center IRCCS Humanitas Research Hospital, Milan, Italien
3Department of Biomedical Sciences, Humanitas University, Milan, Italien
4MDS Unit, Hematology, University of Florence, AOUC, Florence, Italien
5Department of Internal Medicine, Yale School of Medicine and Yale Cancer
Center, Yale University, New Haven, USA
6Hôpital Saint-Louis, Paris, Frankreich
7Mott Cancer Center, Tampa, USA
8Monash University and Monash Health, Melbourne, Australien
9Hospital Universitari Vall d’Hebron, Barcelona, Spanien
10Charles University General University Hospital, Prague, Tschechische Republik
11Hôpital Haut-Lévêque, Centre, Hospitalier Universitaire de Bordeaux,
Bordeaux, Frankreich
12Malignant Haematology & Stem Cell Transplantation, The Alfred, Melbourne,
Australien
13Department of Laboratory Medicine, National Taiwan University Hospital,
Taipei, Taiwan
14Bristol Myers Squibb, Princeton, USA
15Celgene International Sàrl, a Bristol-Myers Squibb Company,
Boudry, Schweiz
16Hematology, Oncology and Transfusion Medicine Center, Vilnius University
Hospital Santaros Klinikos, Vilnius, Lithuania
17Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius,
Lithuania
18IRCCS University Hospital of Bologna, “Seràgnoli” Institute of Hematology,
Bologna, Italien
19Département d’Hématologie Clinique, Université Côte d’Azur, CHU Nice, Nice,
Frankreich
20Department of Leukemia, University of Texas M.D. Anderson Cancer Center,
Houston, USA
Background: ere is a need for tx of anemia due to LR-MDS. We
show interim ecacy and safety results from the phase 3, open-label
COMMANDS trial (NCT03682536) comparing luspatercept vs EA in pts
with ESA-naive LRMDS.
Methods: Pts were ≥18 y, had sEPO < 500 U/L, required RBCTs. Pts
received luspatercept (1.0–1.75 mg/kg; Q3W) or EA (450–1050IU/kg;
Q1W) for ≥ 24 wk. Pts were stratied by baseline RBCT burden, sEPO,
and ring sideroblast (RS) status. Primary endpoint was RBC-TI ≥ 12 wk
with concurrent mean Hb increase ≥ 1.5 g/dL (wk 1–24). Secondary end-
points included HIE ≥ 8 wk, RBCTI 24 wk, and ≥ 12 wk (wk 1–24), sub-
group analyses, response impact of MDS-related gene mutations, safety.
Result: 178 pts were randomized to luspatercept and 178 to EA (31 Aug
2022); median tx durations were 41.6 and 27.0 wk. 86/147 (58.5%) lus-
patercept- and 48/154 (31.2%) EA-treated pts achieved the primary end-
point (P < 0.0001); primary endpoint achievement favored luspatercept
or was similar to EA for all subgroups. Luspatercept tx favored achieving
HI-E ≥ 8 wk, RBC-TI 24 wk, and ≥ 12 wk (wk 1–24). Median RBC-TI ≥
12 wk duration was longer with luspatercept vs EA (126.6 vs 77.0 wk),
and for relevant subgroups, including RS+/−. Pts with SF3B1, SF3B1α,
ASXL1, and TET2 mutations had favorable luspatercept response vs EA.
164 (92.1%) luspatercept and 150 (85.2%) EA pts reported tx-emergent
adverse events (TEAEs); 8(4.5%) and 4 (2.3%) pts, respectively, discontin-
ued due to TEAEs. Most common TEAEs with luspatercept were fatigue
(14.6%), diarrhea (14.6%), hypertension (12.9%), and with EA these were
asthenia (14.2%), diarrhea (11.4%), anemia (9.7%); most TEAEs were
mild/moderate. 4(2.2%) luspatercept and 5 (2.8%) EA pts progressed to
AML; death rates were similar (32[18.0%] vs 32 [18.2%]).
Discussion: Luspatercept demonstrated superiority vs EA with clinically
meaningful RBC-TI and HI-E improvements, favorable outcomes across
MDS mutations, and safety comparable with previous reports.
Conclusion: Luspatercept may be a new tx standard in LR-MDS.
First published: Della Porta MG et al. HemaSphere 2023;7[S3]:S102.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
343
A matching-adjusted indirect comparison (MAIC) of
acalabrutinib (A) with and without obinutuzumab (O) versus
zanubrutinib (Z) in treatment-naïve chronic lymphocytic
leukemia
Frederik Damm1; John N Allan2; Adam S. Kittai3; Dan James4;
Helen Bridge5; Miguel Miranda5; Alan S. M. Yong6; Fady Fam5; Jack Roos6;
Vikram Shetty6; Alan Skarbnik7; Matthew S. Davids8
1Department of Hematology, Oncology, and Cancer Immunology,
Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin
and Humboldt-Universität zu Berlin, Berlin
2Weill Cornell Medical Center, New York, USA, New York, USA
3Division of Hematology, The Ohio State University Comprehensive Cancer
Center, Columbus, OH, USA, Columbus, USA
4Polaris Biostatistics Ltd., Edinburgh, UK, Edinburgh, United Kingdom
5AstraZeneca, Cambridge Biomedical Campus, Cambridge, UK, Cambridge,
United Kingdom
6AstraZeneca, Gaithersburg, MD, USA, Gaithersburg, USA
7Novant Health Cancer Institute, Lymphoma and CLL Program, Charlotte, NC,
USA, Charlotte, USA
8Dana-Farber Cancer Institute, Boston, USA
Background: A and Z have not been compared in head-to-head rand-
omized controlled trial (RCT). We used unanchored MAIC to compare
ecacy/safety of A w/wo O vs. Z in pts with untreated CLL/SLL.
Methods: Individual patient data (IPD) for AO and A arms from
ELEVATE-TN (E-TN) were matched to Z baseline data from cohort 1
of the SEQUOIA RCT. We excluded pts with del(17p) in E-TN to ensure
comparability. Investigator-assessed PFS (INV PFS) was evaluated in pts
with baseline data (AO, n=162; A, n=163; Z, n=241) using Oct 21 data
cut-o (DCO) for E-TN and Oct 22 DCO for SEQUOIA (mFU 58 vs. 44
mo). Matching was based on age, ECOG, Binet stage, bulky disease, b2m,
cytopenia, del(11q), tri12, IGHV and TP53m. Pseudo-IPD for INV PFS
for Z derived from K-M curves. Odds ratios (ORs) of AEs in treated pts
(AO, n=162; A, n=162; Z, n=240) were assessed. To compare the incidence
of AEs, E-TN Sep 20 DCO was used to match the mFU from SEQUOIA
Oct 22 DCO (47 vs. 44 mo).
Result: Eective sample size (ESS) for ecacy was 124 (76%) for AO
and 105 (64%) for A. 36 mo INV PFS was higher with AO (95%; 95% CI:
90–97) than with Z (84%; 95% CI: 79–88), (HR: 0.41; 95% CI: 0.23–0.74).
ere was no dierence for 36 mo INV PFS A(86%; 95% CI: 78–91) vs. Z
(84%; 95% CI: 79–88), (HR: 0.91; 95% CI: 0.53–1.56). ESS for safety was
123 (76%) for AO and 103 (64%) for A. With AO there were no signi-
cant dierences in the odds of having most types of AE, however AO was
associated with higher odds for any grade neutropenia (OR: 2.19; 95% CI:
1.33–3.60) and arthralgia (OR: 2.33; 95% CI: 1.37–3.96) vs. Z. A showed
lower odds for any grade hypertension(HTN) (OR: 0.44, 95% CI: 0.20–
0.99) and no signicant dierences in the odds for other types of AEs vs. Z.
Discussion: In this MAIC AO had longer INV PFS vs. Z, while there was
no evidence of a dierence between A and Z. A was associated with lower
odds of any gr. HTN versus Z. AO was associated with higher odds of any
grade neutropenia and arthralgia vs. Z.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 117
Conclusion: MAIC analyses can only be hypothesis-generating, these
results address an important data gap by comparing these two regimens
where randomized, prospective data are not available.
Disclosure Statement: e authors declare that there are conicts of interest.
econicts were submitted to the congress organizer KUKM GmbH and KUKM
can disclose them if needed.
359
Thiamine-Responsive Megaloblastic Anemia (TRMA)
Syndrome – A Case Presentation
Christina Klötzer1; Anne-Sophie Kubasch1; Madlen Jentzsch2; Jens Uhlig3;
Klaus H. Metzeler1; Franzsika Schnabel4; Johannes Lemke4;
Vladan Vucinic2; Uwe Platzbecker2
1University Leipzig Medical Center, Department of Hematology, Cellular therapy,
Hemostaseology and Infectious Diseases, Leipzig, Deutschland
2University Leipzig Medical Center, Department of Hematology, Cellular therapy,
Hemostaseology and Infectious Diseases, Leipzig, Deutschland
3Hematological Praxis Naunhof, Naunhof
4University Leipzig Medical Center, Clinic for Human Genetics, Leipzig,
Deutschland
Purpose: iamine-responsive megaloblastic anemia syndrome (TRMA)
is a rare autosomal recessive disease with a homozygous or compound-
heterozygous mutation in the SLC19A2 gene characterized by megaloblas-
tic anemia, diabetes mellitus (DM), and sensorineural hearing-loss with
onset in childhood. Folic acid and vitamin B12 in serum are normal with
dysplastic erythropoiesis in the bone marrow oen mimicking myelod-
ysplastic neoplasms (MDN) as a potential dierential diagnosis. Around
200 cases have been described worldwide mainly during childhood. e
substitution of thiamine leads to normalization of anemia, without eects
on hearing-loss or DM. We report here on an adult patient diagnosed with
TRMA with a long history of unexplained anemia.
Methods: e human genetic assessment was performed by molecular
genetic panel diagnostics.
Results: A 38-year-old male Caucasian presented with a 12-year history of
anemia plus insulin dependent DM, optic neuropathy and a cataract since
early childhood. Furthermore, 2019 a drug-eluted stent was placed due to
coronary one-vessel-disease. Prior to presentation in our department, he
received for the rst time two units of red blood cells due to symptomatic
anemia. e laboratory showed megaloblastic anemia with normal white
blood cells and platelet counts. e serum levels of folic acid and vitamin
B12 were normal. e bone marrow smear showed dysplastic erythropoie-
sis with megaloblastic changes, and normal ndings in cytogenetic and
molecular genetic examinations.
A subsequent human genetic evaluation detected a heterozygous variant
in the SLC19A2 gene (c.1001 G>A, p.Gly334Asp) thus conrming the
diagnosis of TRMA. Treatment with oral thiamine 100 mg daily was initi-
ated, and 12 weeks later Hb levels had normalized. A bone marrow smear
demonstrated disappearance of dysplasia.
Discussion: Although extremely rare, TRMA should be included in the
work-up of MDN.
Conclusion: Late-onset TRMA should be considered in adult patients
with indicative comorbidities and a typical phenotype, which may mimic
features of MDS.
Disclosure Statement: e authors declare the following: Novartis, Janssen Cilag,
BMS Celgene, Sobi, Astra Zeneca; Travel Grants: Sobi, Amgen, Gilead,
Janssen, BMS.
437
Simultaneous Inhibition of PI3Kgamma and PI3Kdelta
Deteriorates T-cell Function With Implications for Chronic
Lymphocytic Leukemia
Sebastian Faehling1,2
1DKFZ, Heidelberg, Deutschland
2Medizinische Fakultät Heidelberg, Heidelberg, Deutschland
Background: Chronic lymphocytic leukemia (CLL) remains incurable
even with novel drugs inhibiting crucial enzymes in the B-cell receptor
pathway. Among them, PI3Kδ is conned to leukocytes and constitu-
tively active in CLL making it a promising target. However, non-leukemic
immune cells also rely on PI3K leading to immune-related adverse events
(irAEs) and an impaired function in response to PI3K inhibition.
Methods: We analyzed the in vitro eects of dierent, FDA approved PI3K
inhibitors on T-cells using splenocytes from wildtype and Eµ-TCL1 mice
or human PBMCs from healthy donors and CLL patients. T cells were
stimulated in the presence of the PI3Kδ inhibitors idelalisib and umbral-
isib, the PI3Kγ inhibitor eganelisib, and the dual PI3Kγ and -δ inhibitor
duvelisib, respectively. Aer a preset time, T-cell function and activation
was assessed.
Results: All four PI3K inhibitors reduced T-cell activation and prolifera-
tion. While the single isoform inhibitors were equally eective in murine
T-cells, human T-cells seemed more aected by PI3Kγ inhibition than by
PI3Kδ inhibition. Dual inhibition of PI3Kγ and -δ was even more detri-
mental, suggesting an essential function of both PI3Kγ and -δ in T-cells.
Umbralisib and idelalisib showed no consistent dierences. Interestingly,
the observed eects on T-cells were independent of myeloid cells.
Discussion: Both PI3Kγ and -δ inhibition impairs T-cells which might
explain some of the observed irAEs. While the importance of PI3Kδ for
T-cell function is widely established, PI3Kγ was thought to be less impor-
tant. Our data contradicts this and shows that T-cell function relies on
PI3Kγ and -δ.
Conclusion: Our study showed that PI3Kγ and -δ inhibitors are detrimen-
tal to T-cell function in vitro, and combination of PI3Kγ and -δ inhibition
has strong additive eects.
Indication of source:
1 Faehling et al. Simultaneous Inhibition of PI3Kgamma and PI3Kdelta
Deteriorates T-cell Function With Implications for Chronic Lymphocytic
Leukemia. HemaSphere, 7(3): e840, 2023.
Disclosure Statement: e authors declare no conict of interest.
535
Navigating the (Un-)known – Patients’ Experiences on the Life
Threat Connected to Allogeneic Stem Cell Transplantation
Alinda Reimer1; Carolin Schepers1; Merle Ley1; Berenike Pauli1;
Anne Pralong1; Marco Herling2; Steen T Simon1; Udo Holtick3
1Zentrum für Palliativmedizin der Uniklinik Köln, Köln, Deutschland
2Klinik und Poliklinik für Hämatologie, Zelltherapie, Hämostaseologie und
Infektiologie der Universität Leipzig, Leipzig, Deutschland
3Klinik I für Innere Medizin Onkologie, Hämatologie, Klinische Infektiologie,
Klinische Immunologie, Hämostaseologie, Internistische Intensivmedizin der
Uniklinik Köln, Köln, Deutschland
Background: For patients facing haematological malignancies, allogeneic
stem cell transplantation (allo-SCT) represents an established treatment
option. While oering a high curative potential, the transplantation entails
an elevated risk of mortality as well as high rates of morbidity. A substan-
tial gap exists in the scientic understanding of how patients experience
their existential challenge of confronting their life-threatening condition,
despite the treatment’s curative intent.
Methods: We conducted semi-structured, in-depth interviews with allo-
SCT recipients over the course of their transplantation (before, during,
or aer hospitalization). To systematically analyze interview data, we
employed category-based qualitative content analysis.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts118
Result: Seventeen interviews were conducted. An inclination towards
avoidance of their life threat was emphasized, coupled with a strong focus
on hope for a cure. Challenges arising from a lack of alternative treat-
ments and the uncertain course were further highlighted. Data revealed
that healthcare professionals and the social environment can pose a sup-
portive role. Beyond that, comprehensive information, and knowledge
about the therapeutic course aid in the patients’ ability to deal with the
existential threat.
Discussion: Complex psychological dynamics are revealed, character-
ized by a simultaneous presence of hope for cure and existential fears.
Although patients oen resisted thoughts about these existential threats,
they expressed a strong need for open and honest communication and
information about the treatment course. is highlights the relevance of
healthcare professionals to eectively address these complex emotions and
provide tailored communication.
Conclusion: e ndings emphasize an interplay between hope, avoid-
ance, and psychological distress. To adapt a comprehensive and holistic
approach to treatment, it is desirable to establish avenues for patient edu-
cation and communication, aiming to enhance their ability to cope with
life threat during the treatment course.
Disclosure Statement: e authors declare no conict of interest.
540
Clinical Eectiveness and Safety of Momelotinib Compared
with Continued Ruxolitinib or Best Available Therapy in
Patients with Myelobrosis Who Required Red Blood Cell
Transfusions: Subgroup Analysis of the Phase 3
SIMPLIFY-2 Study
Claire Harrison1; Christoph Scheid2; Alessandro M Vannucchi3; Christian
Recher4; Francesco Passamonti5; Aaron T Gerds6; Juan Carlos Hernández-
Boluda7; Abdulraheem Yacoub8; Shireen Sirhan9; Jun Kawashima10;
Bharat Patel11; Bryan Strouse12; Uwe Platzbecker13
1Guy’s and St Thomas’ Foundation Trust, London, United Kingdom
2Department of Internal Medicine and Center of Integrated Oncology Cologne
Bonn, University of Cologne, Cologne, Deutschland
3University of Florence, Florence, Italy
4University Hospital Center (CHU) of Toulouse, Toulouse, France
5University of Milan Statale, Milan, Italy
6Ceveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
7University of Valencia, Valencia, Spain, Valencia
8University of Kansas, Kansas City, KS, USA
9Jewish General Hospital, McGill University, Montreal, QC, Canada
10Jewish General Hospital, McGill University, Montreal, QC, Canada
11Sierra Oncology, a GSK company, San Mateo, CA, USA
12GSK plc, Philadelphia, PA, USA
13University Hospital Leipzig, Leipzig, Deutschland
Background: To evaluate outcomes in patients (pts) who switched to
Momelotinib (MMB) vs continuing ruxolitinib (RUX) or best available
therapy (BAT) despite transfusion requirement, we present a descriptive
subgroup analysis of pts enrolled in SIMPLIFY-2 (NCT02101268) who
were considered transfusion dependent (TD; ≥4 units of RBC transfusions
in the previous 8 wk or hemoglobin [Hb] level <8 g/dL) or transfusion
requiring (TR; receiving transfusions but not meeting TD criteria) at base-
line (BL).
Methods: SIMPLIFY-2 was an international, multicenter, open-label,
phase 3 clinical trial investigating the ecacy and safety of MMB vs BAT
in pts with MF who had suboptimal responses or hematologic toxicities
while receiving RUX. Pts (N=156) were randomized 2:1 to receive open-
label MMB or BAT, which was RUX in 88.5% of pts. e primary endpoint
was spleen volume reduction ≥35% (SVR35). Total Symptom Score (TSS)
response rate (≥50% reduction; TSS50) and transfusion independence
response (TI-R; no RBC transfusions for ≥12 wk immediately before the
end of wk 24, with all Hb levels ≥8 g/dL) were key secondary endpoints.
Results: In SIMPLIFY-2, 72 of 104 pts (69%) in the MMB arm and 33
of 52pts (63%) in the BAT arm were non-TI at BL, and BL characteris-
tics were balanced between both patient groups. At wk 24, SVR35 was
observed in 7 of 72 pts (10%) treated with MMB and 1 of 33 pts (3%)
treated with BAT. TSS50 was achieved in 21 of 72 pts (29%) treated with
MMB, but there were no responses in the BAT arm. Additionally, TI-R was
achieved in 25 of 72 pts (35%) treated with MMB compared with only 1
of 33 (3%) treated in the BAT arm on RUX. Many responders with MMB
achieved 2or all 3 endpoints (16 of 36 responders [44%]); there were no
dual or triple responses in the BAT arm.
Conclusions: In RUX/BAT-treated pts with MF who required RBC trans-
fusions, continued treatment with RUX/BAT in most pts resulted in poor
treatment outcomes compared with MMB. Overall, these data support
MMB as a potential alternative treatment option for pts with MF who
require RBC transfusions.
ENCORE. © American Society of Hematology (2023) Reused with permission.
Disclosure Statement: e authors declare no conict of interest.
549
Ecacy of Pirtobrutinib in BTK-Inhibitor Pre-treated Relapsed/
Refractory CLL/SLL: Phase 1/2 BRUIN Study Results by Prior
BCL2-Inhibitor Therapy
Jennifer A. Woyach1; Jennifer R. Brown2; Paolo Ghia3; Lindsey E. Roeker4;
Krish Patel5; Toby A. Eyre6; Talha Munir7; Ewa Lech-Maranda8; Nicole
Lamanna9; Constantine S. Tam10; John Seymour11; Nirav N. Shah12;
Chaitra Ujjani13; Bita Fahkri14; Catherine C. Coombs15; Ian Flinn16;
Manisha R. Patel17; Sunita D. Nasta18; Jonathon B. Cohen19;
Alvaro J. Alencar20; Chan Y. Cheah21; Shuo MA10; Joanna M. Rhoades22;
Deepa Jagadeesh23; Pier Luigi Zinzani24; Anders Osterborg25; Koji Izutsu26;
Donald E. Tsai27; Paolo Abada27; Minna Balbas28; Amy S. Ruppert28;
Jian LI28; Wojciech Jurczak29; William G. Wierda30; Stephan Stilgenbauer31
1The Ohio State University Comprehensive Cancer Center, Columbus, USA
2Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA
3Università Vita-Salute San Raaele and IRCCS Ospedale San Raaele, Milano, Italien
4Memorial Sloan-Kettering Cancer Center, New York, USA
5Swedish Cancer Institute - Seattle, Seattle, USA
6Oxford University Hospitals NHS Foundation Trust, Churchill Cancer Center,
Oxford, United Kingdom
7Department of Haematology, St. Jamess University Hospital, Leeds, United
Kingdom
8Institute of Hematology and Transfusion Medicine, Warsaw, Polen
9The Herbert Irving Comprehensive Cancer Center, Columbia University, New York,
USA
10Robert H. Lurie Comprehensive Cancer Center of Northwestern University,
Chicago, USA
11Royal Melbourne Hospital, Peter MacCallum Cancer Centre and University of
Melbourne, Melbourne, Victoria, Australien
12Medical College of Wisconsin, Milwaukee, USA
13Fred Hutchinson Cancer Center, Seattle, USA
14Division of Hematology at Stanford University School of Medicine, Stanford, USA
15University of California, Irvine, USA
16Sarah Cannon Research Institute, Nashville, USA
17Florida Cancer Specialists/Sarah Cannon Research Institute, Nashville, USA
18Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA
19Winship Cancer Institute, Emory University, Atlanta, USA
20Sylvester Comprehensive Cancer Center, Miami, USA
21Linear Clinical Research and Sir Charles Gairdner Hospital, West Australia, Australien
22Rutgers Cancer Institute of New Jersey, New Brunswick, USA
23Cleveland Clinic, Cleveland, USA
24Institute of Hematology “Seràgnoli” University of Bologna, Bologna, Italien
25Karolinska Institute, Stockholm, Schweden
26National Cancer Center Hospital, Chuo City, Japan
27Loxo@Lilly, Indianapolis, USA
28Eli Lilly and Company, Indianapolis, USA
29Maria Sklodowksa-Curie National Research Institute of Oncology, Krakow, Polen
30MD Anderson Cancer Center, Houston, USA
31Universitätsklinikum Ulm, Ulm, Deutschland
Background: Pirtobrutinib, a selective, non-covalent BTKi, has shown e-
cacy and safety in pre-treated CLL/SLL patients (pts) receiving a prior BTKi.
Here, we report CLL/SLL results from BRUIN (NCT03740529) focusing on
pts who received prior BTKi therapy, with or without BCL2i therapy.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 119
Methods: Pts with previously treated B-cell malignancies, including CLL/
SLL, were eligible for pirtobrutinib monotherapy in phase 1/2 BRUIN study.
Endpoints included overall response rate (ORR) including partial response
with lymphocytosis (PR-L), progression-free survival (PFS), and safety.
Results: In total, 282 pts with CLL/SLL who received prior BTKi were
enrolled. Median age was 69 years, 68% were male, and median number
of prior therapies was 4 (range, 1-11). Of the 282 pts, 128 (45%) had also
received prior BCL2i therapy. Pts who received prior BTKi and BCL2i had
more aggressive disease characteristics, more exposure to prior therapies,
and frequently discontinued prior BTKi therapy due to disease progres-
sion (84% vs 71%) compared to BTKi only. e ORR for all pts was 72.0%
(95% CI, 66.4-77.1), including 5 complete responses (CR), 2 nodular par-
tial responses (nPR) and 196 PR. ORR including PR-L was 81.6% (95%
CI, 76.5-85.9), and was consistent among pts who received prior BTKi
and BCL2i (79.7%; 95% CI, 71.7-86.3) or BTKi only (83.1%; 95% CI, 76.2-
88.7). Median PFS was 19.4 months (m) (95% CI, 16.6-22.1) across all
pts, 15.9m (95% CI, 13.6-17.5) in pts who received prior BTKi and BCL2i,
and 23.0m (95% CI, 19.6-28.4) in BTKi only pts. e most common treat-
ment-emergent adverse events (TEAE) were fatigue (36.9%), diarrhea
(28.4%), cough (27.3%), and contusion (26.2%). e most common Grade
≥3 TEAE was neutropenia (28.4%). Grade ≥3 neutropenia was higher
in pts who received prior BCL2i than pts who had not (36.7% v 21.4%).
Seven (2.5%) pts discontinued Pirto due to a TEAE.
Discussion: Pirto demonstrates promising and durable ecacy in
pre-treated CLL/SLL pts with prior BTKi therapy.
Conclusion: Pirto was well-tolerated, regardless of prior BCL2i therapy,
with low-rates of discontinuation due to TEAE.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
567
Pirtobrutinib in Relapsed/Refractory (R/R) Mantle Cell
Lymphoma (MCL) Patients with Prior cBTKi: Updated Safety
and Ecacy including High-Risk Subgroup Analyses from the
Phase 1/2 BRUIN Study
Jonathon B. Cohen1; Nirav N. Shah2; Wojciech Jurczak3; Pier Luigi Zinzani4;
Chan Y. Cheah5; Toby A. Eyre6; Chaitra S. Ujjani7; Youngil Koh8; Won Seog
Kim9; Sunita D. Nasta10; Ian Flinn11; Benoit Tessoulin12; Shuo MA13;
Alvaro J. Alencar14; David J. Lewis15; Jennifer A. Woyach16; Kami J.
Maddocks16; Krish Patel17; Yucai Wang18; Joanna Rhodes19; Constantine S.
Tam20; John F. Seymour21; Hirokazu Nagai22; Julie M. Vose23; Bita Fakhri24;
Marc S. Homann25; Francisco Hernandez-Ilizaliturr26; Andrew D. Zelenetz27;
Anita Kumar27; Talha Munir28; Donald Tsai29; Minna Balbas30; Bin Liu31;
Amy S. Ruppert31; Bastien Nguyen29; Lindsey E. Roeker27;
Michael L. Wang32; Martin Dreyling33
1Winship Cancer Institute, Emory University, Atlanta, USA
2Medical College of Wisconsin, Milwaukee, USA
3Maria Sklodowska-Curie National Research Institute of Oncology, Krakow, Polen
4Institute of Hematology “Seràgnoli” University of Bologna, Bologna, Italien
5Linear Clinical Research and Sir Charles Gairdner Hospital, Western Australia,
Australien
6Oxford University Hospitals NHS Foundation Trust, Churchill Cancer Center,
Churchill Cancer Center, Oxford, United Kingdom
7Fred Hutchinson Cancer Center, Seattle, USA
8Department of Internal Medicine, Seoul National University Hospital, Seoul,
Republik Korea
9Hematology and Oncology at Sungkyunkwan University School of Medicine,
Seoul, Republik Korea
10Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA
11Sarah Cannon Research Institute, Nashville, USA
12Haematology Department, University Hospital, Nantes, Frankreich
13Robert H. Lurie Comprehensive Cancer Center of Northwestern University,
Chicago, USA
14Sylvester Comprehensive Cancer Center, Miami, USA
15University Hospitals Plymouth NHS, Plymouth, United Kingdom
16The Ohio State University Comprehensive Cancer Center, Columbus, USA
17Swedish Cancer Institute - Seattle, Seattle, USA
18Division of Hematology, Mayo Clinic, Rochester, USA
19Rutgers Cancer Institute of New Jersey, New Brunswick, USA
20Alfred Health and Monash University, Melbourne, Victoria, Australien
21Royal Melbourne Hospital, Peter MacCallum Cancer Centre and University of
Melbourne, Melbourne, Australien
22Department of Hematology and Oncology Research, National Hospital
Organization, Nagoya Medical Center, Nagoya, Japan
23University of Nebraska Medical Center, Omaha, USA
24Division of Hematology at Stanford University School of Medicine, Stanford, USA
25The University of Kansas Cancer Center, Kansas City, USA
26Roswell Park Comprehensive Cancer Center, Jacobs School of Medicine and
Biomedical Sciences, University at Bualo, Bualo, USA
27Memorial Sloan-Kettering Cancer Center, New York, USA
28Department of Haematology, St. James‘s University Hospital, Leeds,
UnitedKingdom
29Loxo@Lilly, Indianapolis, USA
29Loxo@Lilly, Indianapolis, USA
31Eli Lilly and Company, Indianapolis, USA
32MD Anderson Cancer Center, Houston, USA
33LMU Klinikum Campus Großhadern, München, Deutschland
Background: Pirtobrutinib is a highly selective, non-covalent (reversible)
Bruton tyrosine kinase inhibitor (BTKi). Here, we report updated results
of pirtobrutinib therapy in all patients (pts) with subset analysis of high-
risk R/R MCL.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts120
Methods: MCL pts received pirtobrutinib monotherapy in the Phase 1/2
BRUIN trial (NCT03740529) Key endpoints included ORR, DOR, PFS,
OS, and safety. A data cut of 05 May 2023 was utilized.
Results: Median age in cBTKi (covalent BTKi) pre-treated pts was 70
years (range, 46-88). 52% had intermediate-risk and 28.3% had high-risk
by sMIPI. Median prior therapy lines was 3 (range, 1-9). Common prior
treatments were anti-CD20 antibody (97%), chemotherapy (90%) and
cBTKi (XX%). 50% had TP53 mutations and 71% had Ki-67 index ≥30%.
ORR for cBTKi pre-treated pts was 49.3% (95% CI, 41.1-57.6), including
15.8% complete responses and 33.6% partial responses. cBTKi naive pts
(n=14) had an ORR of 85.7% (95% CI, 57.2-98.2). ORR among 128 pts
who discontinued a prior cBTKi due to PD and 21 pts who discontinued
for toxicity/other was 43.0%/90.5%, respectively.
Among cBTKi pre-treated pts, median DOR was 21.6 months (m) (95%
CI, 9.2-27.2) at a median follow-up of 24m. e 18/24m DOR rates were
51.9% (95% CI, 37-64.8)/38.9% (95% CI, 22.7-54.8), respectively. e
18/24m DOR rates among cBTKi naïve pts were both 90.0% (95% CI, 47.3-
98.5). Median PFS/OS for cBTKi pre-treated pts was 5.6m (95% CI, 5.3-
9.2)/23.5m (95% CI, 17.1-NE), respectively. In all patients (N=166), the
most frequent treatment-emergent adverse events (TEAEs) were fatigue
(31.9%), diarrhea (22.3%), and dyspnea (17.5%). e most common Grade
≥3 TEAE was neutropenia/neutrophil count decreased (13.3%). Grade ≥3
hemorrhage/hematoma (2.4%) and all-grade atrial brillation (3.6%) were
infrequent. Overall, 8 pts (5%) had TEAEs leading to dose reductions and
5 (3%) had TEAEs leading to pirtobrutinib discontinuation.
Discussion and Conclusion: Pirtobrutinib demonstrates durable ecacy
and favorable safety prole in heavily pre-treated R/R MCL pts with prior
cBTKi therapy and high-risk disease features.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
578
Pirtobrutinib in Heavily Pre-Treated Richter Transformation:
Updated Ecacy and Safety Results with 18-month Median
Survival Follow-up from the Phase 1/2 BRUIN Study
William G. Wierda1; Nirav N. Shah2; Chan Y. Cheah3; David Lewis4;
Marc S. Homan5; Catherine C. Coombs6; Nicole Lamanna7; Shuo MA8;
Deepa Jagadeesh9; Talha Munir10; Yucai Wang11; Toby A. Eyre12;
Joanna Rhodes13; Matthew Mckinney14; Ewa Lech-Maranda15;
Constantine S. Tam16; Wojciech Jurczak17; Koji Izutsu18; Alvaro Alencar19;
Manish R. Patel20; John F. Seymour21; Jennifer Woyach22; Lindsey E.
Roeker23; Philip A. Thompson21; Paolo Abada24; Caleb Ho24; Narasimha
Marella24; Chunxiao Wang25; Amy S. Ruppert26; Binoj Nair24; Hui Liu24;
Donald E. Tsai24; Paolo Ghia27; Othman Al-Sawaf 28
1MD Anderson Cancer Center, Houston, USA
2Medical College of Wisconsin, Brookeld, USA
3Linnear Clinical Research and Sir Charles Gairdner Hospital and University of
Western Australia, Perth, Australien
4University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
5The University of Kansas Medical Center, Kansas City, USA
6University of California, Irvine, USA
7Herbert Irving Comprehensive Cancer Center, Columbia University, New York,
USA
8Robert H. Lurie Comprehensive Cancer Center of Northwestern University,
Chicago, USA
9Cleveland Clinic, Cleveland, USA
10Department of Haematology, St James University Hospital, Leeds,
UnitedKingdom
11Division of Hematology, Mayo Clinic, Rochester, USA
12Oxford University Hospitals NHS Trust, Churchill Cancer Center, Oxford,
UnitedKingdom
13Rutgers Cancer Institute of New Jersey, New Brunswick, USA
14Duke Cancer Institute, Durham, USA
15Institute of Hematology and Blood Transfusion, Warszawa, Polen
16Alfred Health and Monash University, Melbourne, Victoria, Australien
17Maria Sklodowska-Curie National Research Institute of Oncology, Krakow,
Polen
18National Cancer Center Hospital, Tokyo, Japan
19Sylvester Comprehensive Cancer Center, University of Miami, Miller School of
Medicine, Miami, USA
20Florida Cancer Specialists, Sarah Cannon Research Institute, Sarasota, USA
21Peter MacCallum Cancer Center, Royal Melbourne Hospital and University of
Melbourne, Melbourne, Australien
22The Ohio State University Comprehensive Cancer Center, Columbus, USA
23Memorial Sloan-Kettering Cancer Center, New York, USA
24Loxo@Lilly, Indianapolis, USA
25Eli Lilly and Company, Indianapolis, USA
26Eli Lilly and Company, Indianapolis, USA
27Università Vita-Salute San Raaele and IRCCS Ospedale San Raaele, Milano,
Italien
28University Hospital Cologne, Köln, Deutschland
Background: Pirtobrutinib is a highly selective, non-covalent (reversible)
BTKi. Here, we provide updated safety and ecacy of pirtobrutinib in RT
pts from BRUIN (NCT03740529).
Methods: Pts with previously treated histologically conrmed RT were
eligible in the phase 1/2 BRUIN study. Key endpoints included investi-
gator-assessed ORR, DoR, OS, and safety. A data cut of 05 May 2023 was
utilized. Clonal relationship was assessed via IGH rearrangement studies.
Results: Among pts with RT (N=82), median age was 67 (range, 26-95)
and median total number of prior lines of therapy was 4 (range, 0-13).
Pts with prior treatment had median of 2 CLL-directed therapies and 2
RT-directed therapies. Of 29 pts with bone marrow screening, 41.4% had
CLL alone present in BM, 13.8% had DLBCL present and 24.1% had both.
ORR was 50.0% (95% CI, 38.7-61.3) including complete (13.4%) and par-
tial (36.6%) response. For pts who received prior cBTKi therapy, ORR was
45.9% (95% CI 33.1-59.2). Among pts with an RT-directed cBTKi and pts
with prior CLL-directed cBTKi, the ORR was 42.9% (95% CI, 24.5-62.8)
and 43.1% (95% CI, 29.3-57.8), respectively. At median follow-up time of
9.7 months (m), the median DoR for all pts was 7.4m (95% CI, 3.1-19.1)
and the estimated rate at 12m was 45.9% (95% CI, 28.3-61.8). Median
time on treatment for the 41 treatment responders was 8.3m. At median
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 121
survival follow-up (18.3m), median OS for the full RT cohort was 12.5m
(95% CI, 6.9-20.5). At 18m, the OS rate was 44.3% (95% CI, 32.5-55.4).
Frequent treatment-emergent adverse events (TEAEs) were neutro-
penia/decreased neutrophil count (29.3%), fatigue (24.4%) and diar-
rhea, (18.3%). Common Grade ≥3 TEAEs were neutropenia/decreased
neutrophil count (23.2%), thrombocytopenia (11.0%), and anemia
(9.8%). ree pts (3.7%) had TEAEs leading to dose reductions, but no
pt had TEAE leading to discontinuation. Analyses of clonality will be
presented.
Discussion: Follow-up from BRUIN shows encouraging response and OS
in pts with RT.
Conclusion: Pirtobrutinib remains well-tolerated with low rates of dis-
continuation and manageable safety prole.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
712
Presence of the germline variant GFI1-36N promotes genetic
instability in MLL-AF9 leukemic cells and enhances their
sensitivity to CDK4/6 inhibition
Jan Vorwerk1; Kaiyan Sun1; Daria Frank1; Pradeep Kumar Patnana1,2;
Helal Mohammed Mohammed Ahmed1,2; Felix Neumann3,4;
Michael Heuser5; Desiree Kunadt6; Bertram Opalka7; Wolfgang Berdel1;
Georg Lenz1; Ashok Kumar Jayavelu8,9,10,11,12; Nikolas Christian Cornelius
von Bubno2; Cyrus Khandanpour1,2
1Department of Medicine A, University Hospital Münster, Münster, Deutschland
2Department of Hematology and Oncology, University Hospital Schleswig-
Holstein, Lübeck, Deutschland
3Fluorescence Microscopy Facility Münster, Institute of Medical Physics and
Biophysics, University of Münster, Münster, Deutschland
4Rened Laser Systems GmbH, Münster, Deutschland
5Department of Hematology, Hemostasis, Oncology and Stem Cell
Transplantation, Hannover Medical School, Hannover, Deutschland
6Department of Internal Medicine I, University Hospital Dresden, Dresden,
Deutschland
7Department of Hematology and Stem Cell Transplantation, West German
Cancer Center (WTZ), University Hospital Essen, Essen, Deutschland
8Department of Proteomics and Signal Transduction, Max Planck Institute of
Biochemistry, München, Deutschland
9Clinical Cooperation Unit Pediatric Leukemia, German Cancer Research Center
(DKFZ), Heidelberg, Deutschland
10Department of Pediatric Oncology, Hematology, and Immunology, Heidelberg
University, Heidelberg, Deutschland
11Molecular Medicine Partnership Unit, European Molecular Biology Laboratory
(EMBL), Heidelberg, Deutschland
12Hopp Childrens Cancer Center (KiTZ), Heidelberg, Deutschland
Background: e zinc nger protein Growth Factor Independence 1
(GFI1) acts as a key regulator of hematopoiesis. In a single-nucleotide pol-
ymorphism (SNP) of GFI1, GFI1-36N, serine (S) is replaced by asparagine
(N) at position 36. GFI1-36N has a prevalence of 7% in healthy cauca-
sians and 15% in acute myeloid leukemia (AML) patients. Since GFI1 has
recently been shown to be involved in DNA double-strand break repair
(DSBR), we examined whether reduced DSBR in GFI1-36N leukemic cells
promotes leukemogenesis.
Methods: We analyzed DNA damage in human AML samples. To deter-
mine DSBR activity in a murine model of human AML, we knocked in the
human GFI1-36S or GFI1-36N variant gene constructs into the murine
G1 gene locus and induced AML by expressing MLL-AF9.
Results: Both human (p**=0.0080) and murine (p***=0.0003) GFI1-36N
leukemic cells showed increased mutational burden. Upon irradiation,
murine GFI1-36N-MLL-AF9 cells featured 30% more double-strand breaks
(p*=0.0418) and delayed repair. On a molecular level, GFI1-36N exhibited
impaired binding to Ndrg1 resulting in an insucient O6-methylguanine-
DNA methyltransferase (MGMT)-mediated repair. e SNP was associ-
ated with 40% fewer foci of the DSBR key enzyme Rad51 (p**=0.0020),
higher levels of the pro-proliferative CDKs, and inactivation of the tumor
suppressor Rb1,2. As especially CDK4 (p****<0.0001) and CDK6 (p**=0.0042)
protein levels were increased in GFI1-36N leukemic cells, we observed that
these were more susceptible to palbociclib treatment, indicated by 49%
less colony-forming units (p**=0.0063)1,2.
Discussion: We demonstrated that GFI1-36N-MLL-AF9 cells were asso-
ciated with increased CDK levels leading to Rb inactivation. A possible
consequence is a disturbed cell cycle control in GFI1-36N leukemic cells
enhancing their response to CDK4/6 inhibition.
Conclusion: GFI1-36N could act as a marker for a subset of AML patients
that is sensitive to CDK4/6 inhibitors.
References:
1. Vorwerk. HemaSphere. 2022;6(S3):727–8.
2. Vorwerk. Front Oncol. 2022;12:903691.
Disclosure Statement: e authors declare no conict of interest.
748
Expression-linked and R-ISS-Adapted Stratication for rst
line therapy in multiple myeloma patients (ELIAS)
Theo Leitner1; Marion Högner2; Florian Bassermann2; Katja Weisel3;
Jan Krönke4; Axel Nogai4; Stefan Knop5; Leo Rasche6; Pearl van Heteren7;
Evgenii Shumilov8; Raphael Koch9; Inke König10; Kathrin Klinge11;
Kay Horn11; Nikolas Christian Cornelius von Bubno1; Cyrus Khandanpour1
1Klinik für Hämatologie und Onkologie, Universitätsklinikum Schleswig-Holstein,
Campus Lübeck, Lübeck, Deutschland
2Klinik und Poliklinik für Innere Medizin III, Universitätsklinikum rechts der Isar
der TU-München, München, Deutschland
3II. Medizinischen Klinik und Poliklinik, Universitätsklinikum Hamburg-
Eppendorf, Hamburg, Deutschland
4Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und
Tumorimmunologie (CBF), Charité - Universitätsmedizin Berlin, Berlin,
Deutschland
5Klinik für Innere Medizin 5, Schwerpunkt Onkologie /Hämatologie, Klinikum
Nürnberg, Nürnberg, Deutschland, 6Medizinische Klinik und Poliklinik II,
Uniklinikum Würzburg, Würzburg, Deutschland
7Hämatologie und Zelltherapie, Helios Klinikum Berlin-Buch, Berlin, Deutschland
8Medizinische Klinik A, Universitätsklinikum Münster, Deutschland, Münster,
Deutschland
9Institut für Biometrie und Klinische Forschung, Medizinischen Fakultät der
Westfälischen Wilhelms-Universität Münster, Universität Münster, Münster,
Deutschland
10Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck,
Lübeck, Deutschland
11Zentrum für Klinische Studien, Universität zu Lübeck, Lübeck, Deutschland
Background: Newly diagnosed transplant-eligible patients with multiple
myeloma (MM) generally undergo several cycles of induction, followed
by high-dose melphalan (HDM) and autologous stem cell transfusion
(ASCT). In MM patients, HDM improves overall and progression-free
survival (OS and PFS). But it remains to be answered, whether also low
risk patients have an additional benet from HDM therapy compared to
less toxic regimen.
Methods: In this multicentre phase II, interventional, controlled, random-
ized, prospective, and open-label study we evaluate whether patients with
a low-risk prole (R-ISS stage I, low tumor burden, absence of adverse
cytogenetic ndings and a low-risk gene expression prole) might be
suciently treated with intensied consolidation without upfront HDM
chemotherapy. e study investigates the impact and the risk-benet ratio
of three cycles of isatuximab, bortezomib, lenalidomide und dexametha-
sone (I-VRD), stem cell apheresis and high-dose melphalan followed by
ASCT and an isatuximab and lenalidomide based maintenance therapy
as the standard of care control treatment group compared to the experi-
mental group treated with 3 cycles of I-VRD, stem cell apheresis and three
subsequent consolidation cycles of I-VRD followed by an isatuximab and
lenalidomide based maintenance therapy. All patients start with an I-VRD
induction treatment and will be randomized aer 3 cycles.
Result: e primary objective is to show non-inferiority of the experi-
mental arm compared to the control arm regarding the rate of patients
with minimal residual disease (MRD) negativity combined with at least
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts122
a complete remission response according to IMWG criteria at week 40
aer start of induction therapy. Furthermore, we aim to detect possible
dierences in MRD negativity at specic points of time and to characterize
both arms with respect to OS and PFS since randomization, PFS during
second-line treatment since relapse, time to next treatment, and overall
response rate.
Disclosure Statement: e authors declare the following: e study is nanced by
Sano.
771
Symptomatic patients with hyperleukocytic FLT3-ITD
wildtype acute myeloid myeloid leukemia do not benet from
leukapheresis
Kiavasch Mohammad Nejad Farid1; Tim Sauer1; Michael Schmitt1,2;
Carsten Müller-Tidow1; Anita Schmitt1
1Universitätsklinikum Heidelberg, Medizinische Klinik V, Heidelberg,
Deutschland
2Konsortium für translationale Krebsforschung, Deutsches
Krebsforschungszentrum, Nationales Centrum für Tumorerkrankungen,
Heidelberg, Deutschland
Background: Leukostasis in hyperleukocytotic acute myeloid leukemia
(AML) is a medical emergency. e optimal treatment strategy and the
potential benet of incorporating emergency leukapheresis (LA) are still
unclear. We aimed to identify subsets of patients who benet from emer-
gency LA and to establish a therapeutic algorithm for AML patients with
hyperleukocytosis.
Methods: In this single-center retrospective cohort study a total of 20
consecutive patients underwent LA because of clinical symptoms. Overall
survival (OS) analysis was conducted using Kaplan-Meier curve method.
Univariate and multivariate analyses were conducted using Fishers
exact test and multivariate logistic regression. At the time of diagnosis
all patients received standard diagnostics for AML including FLT3-ITD
mutational analysis.
Result: FLT3-ITD mutated (mut) AML patients receiving LA had a median
OS of 437 days (range 5-2,379 days) with a corresponding 14-day-survival
of 92.3%, while FLT3 wildtype (wt) AML patients displayed a signicantly
lower median OS of only 5 days (range 1-203 days) with a corresponding
7-day-survival of 14.3% (p = 0.0006). One-year-survival in the LA group
was 61.5% of FLT3 mut AML patients, whereas none of the FLT3 wt AML
patients presenting with leukostasis receiving LA survived up to one year
aer initial diagnosis.
Discussion: Among patients with clinical symptoms of leukostasis, the
subset of FLT3-ITD mut AML patients showed a better outcome aer
emergency LA. Based on these observations, we established a therapeutic
algorithm for AML patients with hyperleukocytosis.
Conclusion: Although LA is almost exclusively indicated in symptomatic
leukostasis, our results suggest that knowledge of mutational status could
guide early treatment decisions and that FLT3-ITD mutated AML patients
presenting with hyperleukocytosis and symptomatic leukostasis could
benet from LA with a reduction in early mortality.
Disclosure Statement: e authors declare no conict of interest.
784
Longitudinal Assessment of Transfusion Intensity in Patients
with JAK Inhibitor–Naive or –Experienced Myelobrosis
Treated with Momelotinib in the Phase 3 SIMPLIFY-1 and
MOMENTUM Trials
Ruben Mesa1; Martin Griesshammer2; Andrew Perkins3; Yeow Tee Goh4;
Maria Laura Fox5; Donal Mclornan6; Jeanne Palmer7; Lynda Foltz8;
Alessandro M Vannucchi9; Steen Koschmieder10; Francesco Passamonti11;
Sung Eun Lee12; Jun Kawashima13; Bryan Strouse14; Francisco Gonzalez
Carreras15; Stephen Oh16
1Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-
Salem, NC, USA
2University Clinic for Hematology, Oncology, Haemostaseology and Palliative
Care, Johannes Wesling Medical Center, Minden, Deutschland
3Monash University, Melbourne, Australia
4SingHealth Duke-NUS Blood Cancer Center, Singapore General Hospital,
Singapore, Singapore
5Vall d‘Hebron University Hospital, Barcelona, Spain, Barcelona
6University College London Hospitals NHS Trust, London, UK, London
7Mayo Clinic, Phoenix, AZ, USA
8University of British Columbia, Vancouver, BC, Canada
9University of Florence, Florence, Italy, Florence
10RWTH Aachen University and Center for Integrated Oncology Aachen Bonn
Cologne Düsseldorf (CIO ABCD), Aachen, Germany
11University of Milano Statale, Milano, Italy
12Seoul St. Marys Hospital, The Catholic University of Korea, Seoul, South Korea
13Sierra Oncology, San Mateo, CA, USA
14GSK plc, Philadelphia, PA, USA
15GSK, Stevenage, UK, Stevenage
16Washington University School of Medicine, St Louis, MO, USA
Background: We assessed and characterized the impact of Momelotinib
(MMB) and comparators on transfusion burden in patients (pts) with JAK
inhibitor–naive and –experienced myelobrosis (MF) from the phase 3
SIMPLIFY-1 and MOMENTUM trials.
Methods: is analysis evaluated time-dependent transfusion bur-
den in pts enrolled in the phase 3 SIMPLIFY-1 (NCT01969838) and
MOMENTUM (NCT04173494) trials. SIMPLIFY-1 included pts with
JAK inhibitor–naive MF randomized (1:1) to receive MMB or ruxolitinib
(RUX). In MOMENTUM, pts with symptomatic (Myelobrosis Symptom
Assessment Form Total Symptom Score ≥10), anemic (hemoglobin <10
g/dL), JAK inhibitor–experienced MF were randomized (2:1) to receive
MMB or danazol (DAN). Time-dependent transfusion burden was quan-
tied by number of RBC units administered, in a tabular display of base-
line- and treatment-period intensity.
Results: In SIMPLIFY-1 (JAK inhibitor–naive pts), 150 of 213 evaluable
pts (70%) in the MMB arm and 163 of 216 evaluable pts (76%) in the RUX
arm required zero units of RBC transfusion per 28 days at baseline. Of pts
who required zero units of transfusion at baseline, a higher proportion in
the MMB arm (142 of 150 [95%]) maintained a requirement of zero RBC
transfusions during randomized treatment of 24 wks vs the RUX arm (93
of 163 [57%]).
In MOMENTUM (JAK inhibitor–experienced pts), most pts had some
transfusion requirement at baseline, with 26 of 130 (20%) in the MMB arm
and 11 of 65 (17%) in the DAN arm requiring zero units of RBC transfu-
sion per 28 days. During randomized treatment, a higher proportion of pts
in the MMB arm (46 of 130 [35%]) required zero units of RBC transfusion
vs the DAN arm (11 of 65 [17%]).
Conclusions: ese data demonstrate that MMB was associated with bet-
ter maintenance of RBC transfusion intensity and zero RBC transfusion
status vs RUX in pts with MF who were JAK inhibitor naive and showed
greater reduction in RBC transfusion burden from baseline vs DAN in pts
with MF who were JAK inhibitor experienced. Across both trials, ≥85%
of pts treated with MMB maintained or improved transfusion intensity.
ENCORE to ASH (2023).
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 123
817
The function of the BH3-only protein NOXA for BH3-mimetic-
induced apoptosis in lymphoma cells
Marius Anders1; Nahide Yildirim1; Victoria M. Smith2; Sandrine Jayne2;
Martin J. S. Dyer2; Meike Vogler1
1Institute for Experimental Pediatric Haematology and Oncology, Goethe
University, Frankfurt am Main, Deutschland
2Ernest and Helen Scott Haematological Research Institute, University of
Leicester, Leicester, United Kingdom
Background: Programmed cell death maintains tissue homeostasis and
eliminates potentially harmful cells. Critically involved in the regulation
of apoptosis are the BCL-2 (B-cell lymphoma 2) proteins, comprising
anti-apoptotic as well as pro-apoptotic members. Evasion of apoptosis is a
hallmark of cancer. In lymphoma cells, particularly in diuse large B-cell
lymphoma (DLBCL), apoptosis resistance is frequently driven by an over-
expression of anti-apoptotic BCL-2 proteins like the founding member
BCL-2, MCL-1 or BCL-XL. erefore, a highly promising novel strategy
in cancer treatment is the development of so called BH3-mimetics which
functionally mimic BH3-only proteins and counteract the anti-apoptotic
BCL-2 proteins. e rst FDA-approved clinical BH3-mimetic ABT-199/
Venetoclax selectively targets BCL-2 and is used successfully in the treat-
ment of CLL and AML. However, clinical trials show rather poor ecacy
in DLBCL. Lab-based studies indicate that specic inhibitors of MCL-1
(S63845) and BCL-XL (A1331852) might also be eective in DLBCL, out-
lining alternative treatment strategies. Here we investigated the role of the
BH3-only protein NOXA in apoptosis induced by BH3-mimetics target-
ing BCL-2 or BCL-XL. Of note, NOXA selectively binds to MCL-1, and
hence does not directly interfere with BH3-mimetics targeting BCL-2 or
BCL-XL.
Methods: e role of NOXA was investigated using CRISPR/Cas9 medi-
ated knockout in DLBCL cells that are dependent on BCL-2 or BCL-XL
for survival.
Result: Loss of NOXA signicantly reduced sensitivity to ABT-199 or
A1331852, highlighting its importance for apoptosis induced by BH3-
mimetics targeting BCL-2 or BCL-XL. e additional inhibition of MCL-1
could resensitize the cells.
Discussion: ese results indicate that the role of the NOXA/MCL-1 axis
has been underestimated in the treatment of DLBCL with BH3-mimetics
so far.
Conclusion: e ndings can help to use this kind of therapeutics in a
more targeted way for the therapy of lymphoma patients in the future.
Disclosure Statement: e authors declare no conict of interest.
882
Environmental hazards associated with incidence of Multiple
Myeloma in North Rhine-Westphalia - a population-based
ecological analysis
Christine Eisfeld1,2; Lennart Möller1; Kevin Claaßen1; Madeleine Karpinski1;
Johannes Hüsing1; Hiltraud Kajüter1; Andreas Stang1,3,4
1Landeskrebsregister NRW gGmbH, Bochum, Deutschland
2Universitätsklinikum Münster, Medizinische Klinik A, Münster, Deutschland
3Universitätsklinikum Essen, Institut für Medizinische Informatik, Biometrie und
Epidemiologie (IMIBE), Essen, Deutschland
4Boston University, School of Public Health, Department of Epidemiology,
Boston, USA
Background: Multiple Myeloma (MM) is one of the most common
hematological diseases with a multifactorial genesis. Acknowledging that
advanced age is the main risk factor for the development of MM, the body
of evidence about the role of environmental hazards is growing. Among
others, pesticides and farming as well as ambient pollution from particu-
late matter (PM2.5) have been suggested as potentially causal factors.
Methods: Using data from the Cancer Registry of North Rhine-
Westphalia (NRW), we allocated each patient to one of 396 municipali-
ties according to the place of residence at diagnosis. Data on agricultural
land use were retrieved from the regional authorities, mean ambient PM2.5
background concentrations were provided by the Federal Environment
Agency. Environmental data on municipality level were aggregated to
quintiles. Average directly age-standardized incidence rates (standard:
population of NRW) for MM in 2008-2019 were estimated separately
for the top and for the bottom agricultural land use quintiles and PM2.5
concentration quintiles, respectively, and were compared to derive inci-
dence rate ratios (IR).
Result: In the respective bottom and top quintiles, agricultural land use
was <32% and > 67% of total area and ambient PM2.5 concentrations were
<13.5 µg/m3 and > 16.1 µg/m3. IR for agricultural land use were 1.12 (95%-
CI, 1.03-1.22) for men and 1.12 (1.02-1.22) for women. IR for PM2.5 con-
centration were 1.05 (0.98-1.14) for men and 0.98 (0.90-1.06) for women.
Discussion: MM incidence is slightly elevated in the top agricultural land
use quintile as compared to the bottom quintile. ere is no evidence
about elevated MM incidence in the top PM2.5 concentration quintile as
compared to the bottom quintile.
Conclusion: e observed elevated incidence of MM in areas with dom-
inant agriculture is in alignment with international studies. Population-
based evidence about associations between MM and environment might
be enhanced by geospatial regression analysis controlling for potential
confounders.
Disclosure Statement: e authors declare no conict of interest.
952
Impact of EVI1 on cells proliferation and engraftment
suggests therapeutic potential in malignancies
Robin Berner; Susanne Lux; Julius Gräsel; Michael Milsom
Abteilung Experimentelle Hämatologie, Deutsches Krebsforschungszentrum
(DKFZ), Heidelberg, Deutschland
Background: AML is one of the most aggressive diseases of the hemato-
poietic system and the most frequent acute leukemia in adults. Despite an
improved understanding of the underlying molecular processes, treatment
options have mostly stayed the same for a long time and the already bad
prognosis gets even worse in case of specic genetic abnormalities. Some
of them are leading to aberrant high expression of EVI1 and have been
classied as adverse risk. EVI1 expression is predominantly restricted to
HSCs where it modulates the cells self-renewal capacity. In case of overex-
pression, it comes to a massive increase proliferation with a myeloid bias.
Methods: In transplantation studies with mice our lab identied EVI1 as a
target gene that can abrogate the strong engrament defect of HSPCs from
a DNA repair decient FancA-/- mouse model. To further investigate the
role of EVI1, a shRNA-mediated knockdown of EVI1 in human AML-cell
lines was performed.
Result: Retroviral-mediated overexpression of Evi1 in HSPCs from a
mouse model with a defective Fanconi pathway led to robust and sus-
tained multi-lineage engrament in case of transplantation, albeit show-
ing a pronounced myeloid bias and causing AML aer a while, which
was also the case when using WT HSPCs. We explored if leukemia cells
with intact FA pathways and high EVI1 expression rely on it for survival
and therapy resistance. When performing the EVI1 knockdown, we saw
that the proliferation of OCI-M1 cells was decreased compared to WT
cells and poorer survival rates were detected when facing some thera-
peutic agents.
Discussion: Our study provides evidence supporting the signicance of
EVI1 in the context of leukemia, particularly within the framework of FA
and further suggests that EVI1 may also modulate the DDR in non-FA
patients which may contribute to the poor response of EVI1 overexpress-
ing AMLs to chemotherapy.
Conclusion: Our study underscores the urgency of pursuing innovative
treatment strategies to oer renewed hope and improved outcomes for
those who are currently facing poor prognosis and limited therapeutic
options.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts124
Imaging
228
Accuracy of intraoperative specimenPET/CT for PSMA-positive
cancer foci in radical prostatectomy
Theresa Kahl1; Alexandros Moraitis2; Pedro Fragoso Costa2;
Wolfgang Fendler2; Francesco Barbato2; Henning Reis3; Jens Köllermann3;
Lukas Püllen1; Claudia Kesch1; Ulrich Krat1; Jens Kleesiek4;
Boris Hadaschik1; Ken Herrmann2; Christopher Darr1
1Universitätsklinikum Essen, Department of Urology, Essen, Deutschland
2Universitätsklinikum Essen, Department of Nuclear Medicine, Essen,
Deutschland
3Universitätsklinikum Frankfurt, Institute of Pathology, Frankfurt am Main,
Deutschland
4Universitätsklinikum Essen, Institute of Articial Intelligence in Medicine, Essen,
Deutschland
Background: In high-risk prostate cancer (PC) avoidance of unfavor-
able positive surgical margins (PSM) during radical prostatectomy (RP)
is associated with improved cancer control. We evaluate the accuracy of
a novel intraoperative specimenPET/CT (sPET/CT) scanner (AURA10;
XEOS Medical, Ghent, Belgium) for real-time whole gland assessment.
Methods: Six high-risk PC patients undergoing RP with preoperative
18F-PSMA-PET/CT were included in this analysis, median activity of
329.5 MBq 18F-PSMA. Aer removal of the prostate gland, ex vivo imag-
ing was performed with a median time of 282 min p.i. Lesion segmenta-
tion was done using an iterative thresholding method and 30%-threshold
of SUVmax (iso30). Comparison with histopathology included tumor vol-
ume and PSM.
Result: e index lesion was always correctly localized (n=6), signi-
cant lesions in 14 out of 15 (93%). Pearson regression was signicant for
iterative thresholding as well as iso30 with a coecient of 0.8 (p=0.028)
regarding the index lesion. For all signicant lesions, Pearson-coecient
demonstrated a good correlation with a coecient of 0.8 (p<0.001).
In three patients, 6 PSMs were detected in histopathology. 5 of 6 PSM
showed a corresponding tracer signal with both evaluation methods.
However, one lesion was not visualized, which was also not visible in
conventional PET/CT. One patient showed positive lymph nodes in the
mesorectum, which could also be detected intraoperatively.
Discussion: Intraoperative sPET/CT shows promising agreement with
histopathology. However, PSMA-negative foci cannot be assessed. Image-
guided resection of locally advanced tumors or atypical lymph node
metastases demonstrates potential for prospective trials.
Conclusion Intraoperative PET/CT correlates well with histopathology
using either an iterative assessment or 30% threshold. Image-guidance
may help balancing oncological and functional outcomes in the future.
Disclosure Statement: e authors declare no conict of interest.
Lung Cancer
62
Five-year survival in patients with ES-SCLC treated with
atezolizumab in IMpower133: IMbrella A extension
studyresults
Wolfgang Schütte1; Stephen Liu2; Rafal Dziadziuszko3;
Shunichi Sugawara4; Steven Kao5; Maximilian Hochmair6;
Florian Huemer6; Gilberto Castro7; Libor Havel8; Reyes Bernabe Caro9;
Gyorgy Losonczy10; Jong-Seok Lee11; Dariusz Kowalski12; Zoran Andric13;
Raaele Califano14; Andrea Veatch15; Gregory Gerstner16; Marta Batus17;
Stefanie Morris18; Monika Kaul19; Madeena Siddiqui19; Huafei LI20;
Wei Zhang19; Barzin Nabet19; Martin Reck21
1Martha-Maria Hospital, Halle-Dölau, Germany
2Lombardi Comprehensive Cancer Center, Georgetown University, Washington,
DC, USA
3Medical University of Gdańsk, Gdańsk, Poland
4Sendai Kousei Hospital, Sendai, Japan
5Chris O‘Brien Lifehouse, Camperdown, Australia
6Karl Landsteiner Institute of Lung Research and Pulmonary Oncology,
Vienna North Hospital Klinik Floridsdorf, Vienna, Austria
7Ludwig Boltzmann Institute for Lung Health, Klinik Penzing, Vienna, Austria
8Instituto de Cancer do Estado de São Paulo, Hospital das Clínicasda FMUSP,
São Paulo, Brazil
9 Thomayer Hospital, Prague, Czech Republic
10Hospital Universitario Virgen del Rocío, Seville, Spain
11Semmelweis University, Budapest, Hungary
12Seoul National University Bundang Hospital, Seongnam, South Korea
13Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw,
Poland
14Clinical Hospital Centre Bezanijska Kosa, Belgrade, Serbia
15The Christie NHS Foundation Trust and Division of Cancer Sciences,
The University of Manchester, Manchester, UK
16Northwest Medical Specialties, Puyallup, WA, USA
17Illinois Cancer Care, Peoria, IL, USA
18Rush University Medical Center, Chicago, IL, USA
19F. Homann-La Roche Ltd, Basel, Switzerland
20Genentech Inc, South San Francisco, CA, USA
21Roche, Product Development China, Shanghai, China
22Lung Clinic Grosshansdorf, Airway Research Center North, German Center of
Lung Research, Grosshansdorf, Germany
Background: In the Phase III IMpower133 trial (NCT02763579), rst-line
treatment with atezolizumab + carboplatin/etoposide (A+CE) improved
OS and PFS vs placebo + carboplatin/etoposide (P+CE) in patients with
ES-SCLC. At the time of IMpower133 study closure, patients treated with
A+CE were eligible to enrol in the Phase IV, single-arm IMbrella A exten-
sion and long-term observational study (NCT03148418). Given the interest
in long-term OS data for immunotherapy in ES-SCLC, we report patient
outcomes from IMbrella A as an extension of the IMpower133 results.
Methods: Patients enrolled in IMpower133 were eligible for roll-over to
the open-label, non-randomised, multicentre IMbrella A extension study
if they continued to receive atezolizumab at the time of IMpower133 clo-
sure and did not have local access to the study treatment or if they dis-
continued atezolizumab in IMpower133 and were in survival follow-up.
Patients in the P+CE arm were not eligible for enrolment. Survival, treat-
ment status and safety were assessed in IMbrella A.
Result: Median follow-up was 59.4 months in the A+CE arm (IMpower133
and IMbrella A; clinical cuto date [CCOD]: 16 Mar 2023) vs 26.4 months
in the P+CE arm (IMpower133 only; CCOD: 24 Sep 2022). 18 patients
from the A+CE arm of IMpower133 were enrolled in IMbrella A. e
5-year OS rate in the A+CE arm was 12% (IMpower133 and IMbrella A).
Of the 11 patients still alive at the data cuto date, the median age at base-
line was 59 years, 4 patients had an ECOG PS of 1, 2 patients had baseline
brain metastases and none had baseline liver metastases.
Conclusion: is long-term follow-up analysis of IMpower133 patients
enrolled in the IMbrella A extension study provides the rst report of
5-year survival outcomes for patients who received rst-line cancer immu-
notherapy for ES-SCLC and demonstrates that durable survival benet up
to 5 years is possible with A+CE.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 125
Indication of source: WCLC 2023, OA01.04., S.V. Liu et al.
Disclosure Statement: e authors declare the following: Schütte: Research grants,
investigator fees, honoraria, speakers fees from Lilly, Merck, AstraZeneca, Roche,
Boehringer Ingelheim.
93
Pulmonary brosis as risk of lung cancer with occupational
exposure to asbestos, silica and other hazards - systematic
review with meta-analysis
Julia Krabbe; Katja Steens; Sarah Drießen; Thomas Kraus
Institut für Arbeits-, Sozial- und Umweltmedizin, Uniklinik RWTH Aachen,
Aachen, Deutschland
Background: e same molecular pathways important in pulmonary
brosis are involved in lung cancer pathogenesis. is systematic review
investigates whether pulmonary brosis due to occupational exposure is a
risk factor for lung cancer in individuals exposed to occupational airborne
hazards.
Methods: We conducted a comprehensive search in Pubmed, EMBASE,
Web of Science and Cochrane with over a hundred search terms according
to PRSIMA guidelines. Aer screening and extraction, quality of evidence
and eligibility criteria for meta-analysis were assessed. Meta-analysis was
performed using a random-eects model.
Result: 54 studies were included in the systematic review. Meta-analysis
of sub-groups identied silicosis as risk factor for lung cancer when inves-
tigating odds ratio (OR) in autopsy studies (OR 1.47; 95%-CI 1.13-1.90)
and for lung cancer mortality in silicosis patients (OR 3.21; 95%-CI 2.67-
3.87). Studies with adjustment for at least smoking identied a signicant
increase in lung cancer risk (OR 1.58; 95%-CI 1.34-1.87). Qualitative anal-
ysis identied asbestosis as risk factor for lung cancer that could be inde-
pendent of smoking or cumulative exposure. For mixed dusts, coal dusts
and other exposures only insucient or no literature could be included.
Discussion: e ndings of this review are in accordance with previous
studies. A few studies indicate asbestosis as independent risk factor for
asbestos-related lung cancer, however, research with reliable adjustment
for smoking and cumulative exposure is scarce. For silica dust, the lack of
appropriate studies limits the conclusions for the independent association
between silicosis and lung cancer.
Conclusion: is systematic review conrms previous ndings with
asbestosis and silicosis indicating a higher risk of lung cancer in exposed
individuals with brosis? compared to exposed workers without brosis.
Individuals with exposure to asbestos and/or silica should be monitored
for lung cancer especially when asbestosis or silicosis is present.
Disclosure Statement: e authors declare the following: TK and JK give talks on
this topic at workshops, seminars, and conferences for which has been paid for
by the organizers including travel and accommodation. JK, SD and TK have done
research in the past funded by German institutions for statutory accident insurance
and prevention with unrestricted grants to the University hospital RWTH Aachen.
TK is chairman of the Medical Expert Advisory Board on Occupa-tional Diseases
of the German Federal Ministry of Labor and Social Aairs.
99
Asbestos Surveillance Program Aachen (ASPA): Cancer
Mortality among Asbestos Exposed Power Industry Workers
Nelly Otte; Thomas Kraus; Julia Krabbe
Institut für Arbeits-, Sozial- und Umweltmedizin, RWTH Aachen, Uniklinik,
Aachen, Deutschland
Background: e latency period between initial asbestos exposure
and asbestos-related disease can span several decades. e Asbestos
Surveillance Program Aachen (ASPA) aims to detect early asbestos-related
diseases in a cohort of 8,565 power industry workers with a history of
occupational asbestos exposure.
Methods: A mortality follow-up was conducted. Standardized mortal-
ity ratios (SMR) with 95% condence intervals (CI) were calculated for
asbestos-related cancers and stratied by exposure duration, cumulative
dose and smoking behavior. e eect of age at rst exposure, cumulative
exposure and smoking behavior on latency period was examined using
multiple linear regression analysis.
Results: e mortality risk of malignant mesothelioma (MM) increased
with cumulative asbestos exposure but not with exposure duration; the
highest mortality rate (SMR: 21.66; 95% CI 13.58-34.84) was observed in
participants who performed activities with extremely high exposure in a
short period of time. Lung cancer (LC) mortality was not increased (SMR:
0.98; 95% CI 0.80-1.16). Median latency period was 46 (15-63) years for
MM and 44 (15-70) years for LC. Latency was not inuenced by cumula-
tive exposure or smoking habits. Age at rst exposure showed a negative
linear association with latency.
Discussion: Cumulative dose is more appropriate than exposure dura-
tion for estimating the risk of MM. To estimate the risk of MM, activ-
ities with extremely high exposure should be surveyed. e critical age
at death from asbestos-related cancer is between the sixth and eighth
decades of life.
Conclusion: To determine the individual risk of developing MM, cumu-
lative doses as well as data on particularly high exposures should be
collected.
Disclosure Statement: e authors declare no conict of interest.
274
Value of TTF-1 status, PD-L1 TPS and Kras mutation as
prognostic factors in stage IV adenocarcinoma of the lung
treated with carboplatin, pemetrexed and pembrolizumab
according to the KN 189 regimen
Ricarda-Chiara Richter; Dieter Wuerein; Fabian Reich; Joachim Ficker;
Wolfgang Brückl
Pneumologie, Allergologie, Schlafmedizin im Klinikum Nürnberg, Campus Nord,
Nürnberg, Deutschland
Background: e combination of carboplatin, pemetrexed and pembroli-
zumab is currently the preferred standard therapy for patients with met-
astatic non-small cell lung cancer (NSCLC). In addition to PD-L1 tumor
proportion score (TPS), TTF-1 and Kras mutational status are also dis-
cussed as prognostic factors. To date, no routine clinical data have exam-
ined these factors in a homogeneously treated cohort.
Methods: In this retrospective study we analysed data from 110 patients
treated with combination regimen Keynote 189 between 11/18 and 7/22 in
Nuremberg, who had received at least one dose of combination therapy.
Results: Patients with TTF-1- (21.9%) had mPFS and mOS of 3.6 and 11.8
months, respectively, while patients with TTF-1+ had mPFS and mOS of
10.7 and 21.6 months (p=0.253 and 0.251). In contrast, PD-L1 TPS >1%
was associated with signicantly improved mOS of 27 months compared
to TPS of 0% at 12.7 months (p=0.018). Kras mutation including Kras
G12C was not associated with prognosis. e combination of TTF1 status
and PD-L1 separated three distinct prognostic groups with mOS of 45.1,
12.9, and 10.8 months for TTF1/PD-L1+, TTF1 or PD-L1-, and TTF1/
PD-L1-, respectively (p=0.039). In multivariate analysis, only PD-L1 sta-
tus remained an independent prognostic factor for OS.
Discussion: e survival data of our cohort compare very well with
the data of the CTx+IO arm from the KN 189 trial. It is discussed that
TTF-1- is associated with a worse prognosis with pemetrexed-containing
therapies. While we demonstrated a trend toward TTF-1 negativity, the
combination of TTF-1/PD-L1 was associated with even worse survival. At
least these patients should not be treated with this combination. To date, it
is not clear whether other treatment regimens (e.g., 9LA or Poseidon) are
associated with improved survival in these subgroups.
Conclusion: PD-L1 remains the only independent prognostic marker in
the treatment of metastatic NSCLC. While Kras showed no prognostic
value, TTF-1- in patients combined with negative PD-L1-TPS was associ-
ated with a very poor prognosis in terms of overall survival.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts126
342
An observational study to assess the eectiveness and safety
of cemiplimab in patients (pts) with advanced non-small cell
lung cancer (NSCLC) in routine clinical practice within Europe
(CEMI-LUNG)
Christian Geßner1; Frank Griesinger2; Riyaz Shah3; Toby Talbot4;
Satish Venkateshan5; Ashok Krishna6; Alex Seluzhytsky6; David Marsden7
1Department of Pulmonary and Bronchial Medicine, Pulmonary Oce/Medical
Spe, Leipzig, Deutschland
2Department of Hematology and Oncology; Pius Hospital Oldenburg,
University Medicine, Oldenburg, Deutschland
3Department of Medical Oncology, Kent Oncology Centre, Kent,
United Kingdom
4Department of Clinical Oncology, Royal Cornwall Hospital, Cornwall,
United Kingdom
5Department of Medical Aairs, Oncology, Regeneron Pharmaceuticals, Inc.,
Tarrytown, USA
6Department of Medical Aairs, Sano, Cambridge, USA
7Department of Medical Aairs, Sano, Reading, United Kingdom
Background: Blockade of the programed cell death 1 (PD-1) pathway is
the mainstay for the rst-line (1L) treatment of pts with advanced NSCLC
without targetable oncogenic alterations. Cemiplimab, a PD-1 inhibitor,
has improved overall survival (OS) and progression free survival (PFS)
vs chemotherapy in 1L treatment of pts with advanced NSCLC with pro-
gramed cell death-ligand 1 (PD-L1) expression ≥50% and without driver
aberrations. Cemiplimab was licensed as 1L monotherapy in this pt popu-
lation by the FDA (Feb 2021) and EMA (May 2021) based on results from
EMPOWER-Lung 1 (NCT03088540). Currently, there are no prospective
data on the eectiveness and safety of cemiplimab in advanced NSCLC in
routine clinical practice. Such data could provide additional evidence to
guide treatment and optimal use as per the licensed indication, including
pts not typically included in or excluded from clinical trials. CEMI-LUNG
(NCT05363319) is a pragmatic, prospective, noninterventional, observa-
tional cohort study that aims to address these data gaps.
Methods: Pts with advanced NSCLC who are initiating a licensed cemi-
plimab-based regimen as part of their routine clinical practice are eligible.
Study visits will follow the standard-of-care schedule and data will be col-
lected every 3 months on treatment, and every 6 months for 36 months
following treatment discontinuation (maximum study duration, 72
months) until death, loss to follow-up, study withdrawal, or end of study
period, whichever occurs rst.
e study plans to enroll ~300 pts across 30 European sites. Decisions
regarding treatment will be made by the treating physician in accordance
with local clinical practice.
e primary objective is to assess OS. Secondary objectives are to describe
objective response rate, time to response, time to rst subsequent anti-NS-
CLC treatment, duration of response, PFS, and the incidence and severity
of adverse events. ree interim analyses are planned in addition to the
nal analysis. is study is open for enrollment.
Result: Not applicable.
Discussion: Not applicable.
Conclusion: Not applicable.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
345
ctDNA dynamics and neoadjuvant treatment responses in
patients with resectable NSCLC from the phase 3 AEGEAN trial
Christian Schumann1; John V. Heymach2; David Harpole3;
Testuya Mitsudomi4; Janis M. Taube5; Gabriella Galy6;
Maximilian Hochmair7; Thomas Winder8; Ruslan Zukov9;
Gabriel Garbaos10; Shugeng Gao11; Hiroaki Kuroda12; Jian You13;
Kang-Yun Lee14; Lorenzo Antonuzzo15; Mike Aperghis16; Gary J. Doherty16;
Helen Mann16; Tamer M. Fouad17; Martin Reck18; Silvan Becker19
1Pneumology, Thoracic Oncology, Sleep and Respiratory Critical Care Medicine,
Clinics Allgäu, Kempten and Immenstadt, Germany
2Department of Thoracic/Head and Neck Medical Oncology, The University of
Texas, M.D. Anderson Cancer Center, Houston, Texas, USA
3Department of Surgery, Duke University Medical Center, Durham, North
Carolina, USA
4Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty
of Medicine, Osaka-Sayama, Japan
5Bloomberg–Kimmel Institute for Cancer Immunotherapy, Johns Hopkins
Kimmel Cancer Center, Baltimore, Maryland, USA
6Pest County Pulmonology Hospital, Törökbálint, Hungary
7Department of Respiratory and Critical Care Medicine, Karl Landsteiner
Institute of Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna,
Austria
8Department of Hematology, Oncology, Gastroenterology and Infectiology,
Landeskrankenhaus Feldkirch, Feldkirch, Austria
9Krasnoyarsk State Medical University, Krasnoyarsk, Russia
10Fundación Estudios Clínicos, Santa Fe, Argentina
11Thoracic Surgery Department, National Cancer Center/National Clinical
Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
12Department of Thoracic Surgery, Aichi Cancer Center Hospital, Aichi, Japan
13Department of Lung Cancer, Tianjin Medical University Cancer Institute and
Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research
Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin,
China
14Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical
University, New Taipei City, Taiwan
15Clinical Oncology Unit, Careggi University Hospital, Department of
Experimental and Clinical Medicine, University of Florence, Florence, Italy
16AstraZeneca, Cambridge, United Kingdom
17AstraZeneca, New York, USA
18Lung Clinic Grosshansdorf, Airway Research Center North, German Center for
Lung Research, Grosshansdorf, Germany
19Department of Oncology, Agaplesion Markus Krankenhaus Frankfurt,
Frankfurt, Germany
Background: Among patients (Pts) with resectable (R) NSCLC in the
AEGEAN trial, perioperative durvalumab (D) + neoadjuvant chemother-
apy (CT) signicantly improved pathological complete response (pCR)
and event-free survival (EFS), with manageable safety, vs. neoadjuvant
CT alone. Here we report exploratory analyses of potential associations
between ctDNA and pCR or major pathological response (MPR) during
the neoadjuvant treatment (Tx) phase in AEGEAN.
Methods: AEGEAN is a double-blind, placebo (PBO)-controlled ran-
domised study (NCT03800134). Adults with Tx-naïve R-NSCLC (stage
II–IIIB[N2]; AJCC 8th ed) and ECOG PS 0/1 were randomized (1:1) to
receive neoadjuvant platinum-based CT + either D 1500 mg or PBO IV
(every 3 weeks [Q3W], 4 cycles) prior to surgery (Sx), followed by D 1500
mg or PBO IV (Q4W, 12 cycles), respectively, aer Sx. Pts were stratied
by disease stage (II vs III) and PD-L1 tumour cell expression (<1% vs ≥1%;
Ventana SP263). Following a protocol amendment, conrmation of EGFR/
ALK status was required prior to randomization. Pts with documented
EGFR/ALK aberrations were excluded from the modied ITT population
for ecacy analyses. e primary endpoints were pCR, evaluated centrally
(per IASLC), and EFS (using RECIST v1.1), evaluated by BICR. Plasma
samples were collected at protocol-specied timepoints, including prior
to each cycle of neoadjuvant Tx. Analysis of ctDNA was performed using
patient-specic tumour-informed assays, following identication of muta-
tions by whole-exome sequencing of diagnostic tissue.
Expected Results: To date, ctDNA analysis has been performed for 198
Pts in the population included in the interim analysis of pCR. e reported
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 127
results will include baseline characteristics of analysed Pts; ctDNA lev-
els and dynamics during neoadjuvant Tx; and potential associations of
ctDNA variables, including ctDNA clearance, with baseline characteris-
tics, pCR or MPR.
Expected Conclusions: ese exploratory analyses are expected to shed
light on the predictive utility of ctDNA in Pts treated with neoadjuvant
D + CT.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
360
TROPION-Lung05: Datopotamab deruxtecan (Dato-DXd) in
previously treated non-small cell lung cancer (NSCLC) with
actionable genomic alterations (AGAs)
Akin Atmaca1; Luis Paz-Ares2; Myung-Ju Ahn3; Aaron Lisberg4; Satoru
Kitazono5; Byoung Chul Cho6; George Blumenschein Jr7; Elaine Shum8;
Elvire Pons Tostivint9; Yasushi Goto10; Kiyotaka Yoh11; Rebecca Heist12;
Paul Baas13; David Planchard14; Maurice Pérol15; Enriqueta Felip16;
Wu-Chou Su17; Hong Zebger-Gong18; Lan Lan19; Chelsea Liu19;
Jacob Sands20; Niels Reinmuth21
1Krankenhaus Nordwest, Frankfurt am Main, Deutschland
2Hospital Universitario 12 de Octubre, Madrid, Spanien
3Samsung Medical Center, Seoul, Republik Korea
4David Geen School of Medicine at UCLA, Los Angeles, USA
5The Cancer Institute Hospital of JFCR, Tokyo, Japan
6Severance Hospital, Seou, Seoul, Republik Korea
7University of Texas MD Anderson Cancer Center, Houston, USA
8NYU Perlmutter Cancer Center, New York, USA
9University Hospital of Nantes, Nantes, Frankreich
10National Cancer Center Hospital, Tokyo, Japan
11National Cancer Center Hospital East, Kashiwa, Japan
12Massachusetts General Hosp. Cancer Ctr., Boston, USA
13The Netherlands Cancer Institute, Amsterdam, Niederlande
14Gustave Roussy, Department of Medical Oncology, Villejuif, Frankreich
15Centre Léon Bérard, Lyon, Frankreich
16Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology,
Barcelona, Spanien
17National Cheng Kung University Hospital, Tainan, Taiwan
18Daiichi Sankyo Europe GmbH, Munich, Deutschland
19Daiichi Sankyo, Inc, Basking Ridge, USA
20Dana-Farber Cancer Institute, Boston, USA
21Asklepios Klinik Gauting GmbH, Gauting, Deutschland
Background: Once targeted therapies and platinum-based chemotherapy
(PBC) become ineective in patients (pts) with advanced/metastatic (a/m)
NSCLC with AGAs, few treatments with limited benet are available. Dato-
DXd is an antibody-drug conjugate composed of a TROP2 directed mono-
clonal antibody covalently linked to a highly potent cytotoxic payload via
a stable, tumor-selective, tetrapeptide-based cleavable linker. We report
primary results from the global, open-label, phase 2 TROPION-Lung05
trial (NCT04484142) evaluating Dato-DXd in pts with a/m NSCLC with
AGAs progressing on or aer ≥1 AGA-specic therapy and PBC.
Methods: Dato-DXd 6 mg/kg was given every 21 days to pts with a/m
NSCLC, ECOG status 0 or 1, and ≥1 documented AGA in EGFR, ALK,
ROS1, NTRK, BRAF, MET exon 14 skipping, or RET. e primary end-
point was conrmed objective response rate (cORR) by blinded indepen-
dent central review (BICR). Secondary endpoints included duration of
response (DOR) and disease control rate (DCR) by BICR, and safety.
Result: A total of 137 pts received ≥1 dose and had a median age of 61.0
y; 71.5% had ≥3 prior lines of therapy for a/m NSCLC; 56.9% had EGFR
mutations. As of 14 Dec 2022, 85.4% discontinued therapy, 63.5% had dis-
ease progression, and 49.6% died. Median pt duration on study was 15.2
months (mo); cORR was 35.8%, DCR, 78.8%, and median DOR, 7.0 mo;
similar response was seen in pts with EGFR mutations. e most common
grade ≥3 TEAEs were stomatitis (9.5%), anemia (5.8%), and increased
amylase (5.8%).
Conclusion: Dato-DXd showed encouraging antitumor activity, with a
clinically meaningful and durable response, in heavily pretreated pts with
NSCLC with AGAs. e safety prole was manageable and consistent with
prior safety observed with Dato-DXd. ese data support inclusion of pts
with AGAs in the TROPION-Lung01 study (NCT04656652).
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
393
Increase of stage IV NSCLC diagnoses during the COVID-19
pandemic, a real-world data study of the Network Oncology
registry
Anja Thronicke1; Christian Grah2; Hannah Wüstefeld2; Patricia Grabowski3;
Juliane Roos3; Gerrit Grieb4; Friedemann Schad1,3
1Research Institut Havelhöhe Berlin at Gemeinschaftskrankenhaus Havelhöhe,
Berlin, Deutschland
2Hospital Gemeinschaftskrankenhaus Havelhöhe, Lung Cancer Center, Berlin,
Deutschland
3Hospital Gemeinschaftskrankenhaus Havelhöhe, Interdisciplinary Oncology
and Palliative Care, Berlin, Deutschland
4Hospital Gemeinschaftskrankenhaus Havelhöhe, Department of Plastic Surgery
and Hand Surgery, Berlin, Deutschland
Background: Lung cancer care has been signicantly altered during the
COVID-19 pandemic worldwide. Increasing data indicate shis towards
the diagnoses of advanced tumors during the pandemic years. e aim of
this study was to evaluate tumor stage shis of lung cancer, especially non-
small cell lung cancer (NSCLC) patients, during the pandemic compared
to the pre-pandemic years.
Methods: Demographic, tumor- and treatment-related data from newly
diagnosed lung cancer patients from an accredited German cancer center
were retrieved from the Network Oncology registry and were statistically
descriptively analyzed. e study has been approved by the ethics commit-
tee of the Medical Association Berlin (Eth-27/10).
Result: In total 1118 lung cancer patients were included in the regis-
try study. When looking at NSCLC, signicant tumor stage shis were
observed during 2021 and 2022: while the proportion of UICC stage IV
NSCLC increased by 10.7% (p=0.03) during the rst pandemic year, the
proportion of UICC stage II NSCLC decreased by 8.2% (p=0.01) in the
following year compared to the pre-pandemic years. No signicant shis
were observed for SCLC patients. Finally yet importantly, a 12% decline
of lung cancer diagnoses in 2021 and a 17.2% decline in 2022 was docu-
mented compared to the pre-pandemic years.
Discussion: COVID-19-related diagnostic and treatment delays and
patients reluctance have led to clinically meaningful shis towards higher
tumor stages as well as decreases of lung cancer diagnoses in a certied
German lung cancer center.
Conclusion: A signicant increase of stage IV and decrease of stage II of
NSCLC diagnoses during the COVID-19 pandemic were observed. In the
near future, cancer care, patients health-related quality of life and the lung
cancer mortality due to tumor stage shis will need to be evaluated.
Disclosure Statement: e authors declare the following: FS reports grants from
AstraZeneca GmbH, Abnoba GmbH, Iscador AG, and Helixor Heilmittel GmbH
outside the submitted work. e other authors declare no conict of interest. CG
reports grants or honoraria from AstraZeneca GmbH, Weleda AG and Chie-
si GmbH outside the submitted work. HW reports grants or hono-raria from
AstraZeneca outside the submitted work. e other authors declare no conict of
interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts128
501
The feasibility of acute endurance training in lung cancer
patients and its eects on exercise enjoyment
Jenny Hoart1; Lutz Vogt1; Frieder Krause2; Katharina Graf 2; Elke Jäger2;
Nils Scharath2
1Goethe-Universität Frankfurt am Main, Frankfurt am Main, Deutschland
2Krankenhaus Nordwest, Frankfurt am Main, Deutschland
Background: Substantial evidence underlines the benets of targeted
exercise on treatment-related side eects in cancer patients and sub-
populations with high symptom burdens, e.g., persons with lung cancer.
However, specic exercise modes such as the time-saving high intensity
interval training (HIIT) are less well studied. is study investigates the
feasibility and enjoyment of HIIT in lung cancer patients using spiroer-
gometry and questionnaires.
Methods: A standardized controlled-randomized two-arm design with
lung cancer patients during or aer cancer treatment was conducted.
Aer a maximal, incremental spiroergometry at baseline, the intervention
group participated in one HIIT for 35 minutes, while the control group
engaged in respiratory training (CG). Both groups completed question-
naires regarding quality of life, physical activity and enjoyment.
Result: Out of 16 participants (f = 9, 59.8 ± 6.1y), the dropout rate was 0%.
No adverse events were observed. Both groups showed high positive and
low negative ratings in the enjoyment questionnaire aer baseline testing
(35.7± 3,6; 9.3 ± 2.7) and aer both intervention (HIIT: 37.1 ± 4.3, 9.1±
2.6; p > .05, CG: 38 ± 3.8; 9.3 ± 4; p > .05), indicating a high level of enjoy-
ment. Feasibility of HIIT was reected in values of maximum heart rate
(143.1 ± 11.9) and subjective perception of eort (13.2 ± 0.5).
Discussion: e HIIT was feasible and safe for the lung cancer patients
in our study. Our results show high levels of exercise enjoyment without
signicant dierences between both interventions but indicate a trend for
increased enjoyment aer both interventions compared to the maximal
exercise test.
Conclusion: HIIT seems to be feasible and safe in lung cancer patients
post-therapy and shows comparable enjoyment ratings as respiratory
training despite the high intensity.
1 Heredia-Ciuró, A., Fernández-Sánchez, et al. (2022). High-intensity interval
training eects in cardiorespiratory tness of lung cancer survivors: a
systematic review and meta-analysis.Supportive care in cancer: MASCC,30(4),
3017–3027.
Disclosure Statement: e authors declare no conict of interest.
511
Five-year Survival Outcome of patients with synchronous
oligometastatic or locally advanced Non-small cell lung cancer
after denitive primary treatment: Results from the West
German Cancer Center, a prospective registry trial
Maja Guberina1,2,12; Christoph Pöttgen2,12; Nika Guberina2,12; Marcel
Wiesweg3,12; Martin Metzenmacher3,12; Cedric Richlitzki2,4,12; Christian
Homann2,12; Wilfried Eberhardt3,12; Michael Forsting5,12; Ken
Herrmann1,6,12; Dirk Theegarten7,12; Servet Bölükbas8,12; Clemens Aigner9;
Kaid Darwiche10,12; Martin Stuschke1,2,11,12; Martin Schuler1,3,11,12
1DKTK Standort Essen, Essen, Deutschland
2Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Essen, Essen,
Deutschland
3Innere Klinik (Tumorforschung), Essen, Deutschland
4Klinik und Poliklinik für Radioonkologie und Strahlentherapie, TUM, München,
Deutschland
5Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie,
Essen, Deutschland
6Klinik für Nuklearmedizin, Essen, Deutschland
7Institut für Pathologie, Essen, Deutschland
8Klinik für Thoraxchirurgie und Thoraxendoskopie, Westdeutsches
Krebszentrum, Universitätsmedizin Essen - Ruhrlandklinik, Universitätsklinikum
Essen, Universität Duisburg-Essen, Essen, Deutschland
9Klinik für Thoraxchirurgie, Comprehensive Cancer Center, Medizinische
Universität Wien, Wien, Österreich
10Klinik für Pneumologie, Interventionelle Bronchologie, Essen, Deutschland
11DKFZ, Heidelberg, Deutschland
12Nationales Centrum für Tumorerkrankungen (NCT) West, Essen, Deutschland.
Background: In oligometastatic non-small cell lung cancer (OMDLC),
locally advanced tumor extension is an unfavorable prognostic factor.
e aim of this study is to determine long-term prognosis in OMDLC
aer loco-regional radiochemotherapy (RCT) and to compare it with
patients (pt) with locally advanced stage-III NSCLC aer introduction of
immune-checkpoint inhibitors (ICIs) and new precision radiotherapeutic
techniques.
Methods: All consecutive pts, who received induction-chemotherapy
(INDCTX) and combined RCT from 01/2017 to 02/2020 were included.
Results: A total of 288 pts met inclusion criteria: 220 presented with stage-
III (158 with def.RCT, 62 with a trimodality approach), 68 with OMDLC.
Overall survival (OS) at 5 years was 34.9% (95%CI: 27.4%-42.8%) for pts
with NSCLC stage-III and def. RCT, 28% (95%CI: 16.8%-40.2%) for the
OMD cohort (p= 0.1570). ECOG, ICI-line and age as well as CRP-values
are important prognostic parameters for OS (p< 0.03). Comparing meta-
static-site in pairwise-correlation in the whole cohort there were striking
dierences in OS (p= 0.0042), especially OS was better in pts with solitary
brain metastases. During the same period, 39 pts with NSCLC stage-III
were treated with INDCTX, def.RCT and primary durvalumab consoli-
dation. Among OMDLC pts, 14.1% received immunotherapy as part of
initial multimodality therapy.
Discussion: OS of pts with cT4/cN2-3 cM0 tumors and durvalumab-con-
solidation aer def.RCT was signicantly better than of the remaining
pts at 4/5years: 75.1±8.9% and 65.7±11.7%, respectively (p< 0.001). With
modern staging methods, a signicant percentage of pts present with
OMDLC. In OMDLC with solitary metastasis or ICI prognosis was better
than without, especially in pts with solitary brain metastases.
Conclusion: Long-term survival between pts with OMDLC selected at the
center for radical thoracic therapy and primarily technically or function-
ally inoperable stage-III pts was comparable. In pts with PD-L1 expression
early inclusion of immune-check point inhibitors may improve survival
outcomes.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 129
544
Process evaluation of the implementation of the DigiNet
intervention: Facilitating and inhibiting factors
Vanessa Mildenberger1; Leonie Eilers2; Florian Kron2,3,4; Anna Kron3,5;
Jürgen Wolf3,5; Anika Kästner6; Wolfgang Homann6; Anna Spier1;
Dusan Simic1; Stephanie Stock1
1Institute for Health Economics and Clinical Epidemiology, Faculty of Medicine
and University Hospital Cologne, University of Cologne, Cologne, Deutschland
2KCM KompetenzCentrum für Medizinoekonomie, FOM Hochschule für
Oekonomie & Management gemeinnützige Gesellschaft mbH, Essen,
Deutschland
3Department I of Internal Medicine, Center for Integrated Oncology (CIO)
Aachen Bonn Cologne, Faculty of Medicine and University Hospital Cologne,
Cologne, Deutschland
4VITIS Healthcare Group, Cologne, Deutschland
5National Network Genomic Medicine (nNGM) Lung Cancer, Faculty of Medicine
and University Hospital Cologne, Cologne, Deutschland
6Institute for Community Medicine, Section Epidemiology of Health Care and
Community Health, University Medicine Greifswald, Greifswald, Deutschland
Background: e project DigiNet aims at improving personalized lung
cancer care in Germany through digital connection of specialized academic
centers with practitioners via a shared project database. is is used to trans-
mit molecular diagnostics from the centers to determine, monitor and guide
targeted therapy. Furthermore, patient-reported outcomes are evaluated.
As this new form of care is a complex intervention, process evaluation is
required, which will examine the implementation. For this purpose, facili-
tating and inhibiting factors as determinants of change were identied.
Methods: Since project start qualitative interviews were conducted with
health care providers. A semi-structured interview guide was used, which
was developed based on a systematic literature review. e data material
was analyzed using MAXQDA according to Mayrings qualitative content
analysis.
Results: 15 Interviews were conducted via Zoom with treating oncologists
and study assistants. e close networking of all project participants, espe-
cially with the specialized centers as well as the documentation of treat-
ment data in a more structured manner using the database were identied
as facilitating factors. Patients can benet from having their condition
systematically assessed through patient-reported outcomes. Inhibiting
factors include a high burden of bureaucratic processes, especially those
related to patient information and consent.
Discussion: Practitioners can guide targeted therapy more eectively as
the database leads to a more structured documentation and digitalization
facilitates networking of cooperating practitioners. is improves patient
care. However, due to the additional eort during the project period, the
integration of the complex intervention into existing treatment structures
is still challenging.
Conclusion: e results of the process evaluation demonstrate that
DigiNet, as a new form of care, has the potential to dynamically improve
personalized lung cancer therapy.
Disclosure Statement: e authors declare no conict of interest.
571
Six-year survival and HRQoL outcomes with 1L nivolumab
(N) + ipilimumab (I) vs chemotherapy (C) in patients with
metastatic NSCLC (mNSCLC) from CheckMate227
Suresh S. Ramalingam1; Tudor-Eliade Ciuleanu2; Reyes Bernabe Caro3;
Makoto Nishio4; Hideaki Mizutani5; Jong-Seok Lee6; Clarisse Audigier-
Valette7; Randeep Sangha8; Laszlo Urban9; Jacobus A. Burgers10;
Adam Pluzanski11; Ki Hyeong Lee12; Bogdan Zurawski13; Michael
Schenker14; Solange Peters15; Luis Paz-Ares16; Hossein Borghaei17;
Kenneth O’byrne18; Julie R. Brahmer19; Ravi G. Gupta20; Judith Bushong20;
LI LI20; Yong Yuan20; Steven Blum20; Martin Reck21
1Winship Cancer Institute, Emory University, Atlanta, USA
2Institutul Oncologic Prof. Dr. Ion Chiricuta and University of Medicine and
Pharmacy Iuliu Hatieganu, Cluj-Napoca, Rumänien
3Hospital Universitario Virgen del Rocio, Instituto de Biomedicina de Sevilla,
Seville, Spanien
4Cancer Institute Hospital of the Japanese Foundation for Cancer Research,
Tokyo, Japan
5Saitama Cancer Center, Saitama, Japan
6Seoul National University Bundang Hospital, Seongnam, Republik Korea
7Hôpital Sainte Musse, Toulon, Frankreich
8Cross Cancer Institute, Edmonton, Kanada
9Mátrai Gyógyintézet, Matrahaza, Ungarn
10The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital,
Amsterdam, Niederlande
11Maria Sklodowska-Curie National Research Institute of Oncology,
Warsaw, Polen
12Chungbuk National University Hospital, Cheongju-si, Republik Korea
13Ambulatorium Chemioterapii, Bydgoszcz, Polen
14Sf Nectarie Oncology Center, Craiova, Rumänien
15Lausanne University Hospital, Lausanne, Schweiz
16Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid,
Madrid, Spanien
17Fox Chase Cancer Center, Temple Health, Philadelphia, USA
18Princess Alexandra Hospital, Translational Research Institute and Queensland
University of Technology, Brisbane, Australien
19Bloomberg–Kimmel Institute for Cancer Immunotherapy, Johns Hopkins
Kimmel Cancer Center, Baltimore, USA
20Bristol Myers Squibb, Princeton, USA
21Airway Research Center North, German Center for Lung Research,
LungenClinic Grosshansdorf, Grosshansdorf, Deutschland
Background: In CheckMate 227 Pt 1 (NCT02477826), 1L N + I showed
long-term durable OS benet vs C in pts with mNSCLC. Here we present
6-y outcomes, including association of OS with response/tumor burden
reduction and HRQoL.
Methods: Adults with tx-naive stage IV/recurrent NSCLC, no known
EGFR/ALK alterations, and ECOG PS ≤1 were enrolled. Pts were ran-
domized 1:1:1 to N + I, N, or C (tumor PD-L1 ≥1%) or N + I, N + C,
or C (tumor PD-L1 <1%). Assessments included OS, PFS, ORR, DOR,
and OS by best response and tumor burden reduction from baseline
(responders: complete/partial response [CR/PR] with ≥80% reduction, PR
with 50–<80% reduction, or PR with 30–<50% reduction; non-respond-
ers: stable/progressive disease) and by baseline HRQoL using EQ-5D-3L
(higher scores indicated better HRQoL).
Result: At 73.4 mo min follow-up (f/u; database lock: Feb 21, 2023), N + I
continued to show OS benet vs C in pts with tumor PD-L1 ≥1% or <1%;
6-y OS rates were 22% vs 13% and 16% vs 5%, respectively. Consistent
clinical benet was noted across additional ecacy endpoints in all pts
regardless of tumor PD-L1 status and in pts alive at 6 y. More responders
had tumor burden reduction ≥80% with N + I vs C (tumor PD-L1 ≥1%:
15% vs 3%; tumor PD-L1 <1%: 8% vs 1%); 6-y OS rates were also higher
(59% vs 42%; 77% vs 0%). In pts who completed EQ-5D-3L visual analog
scale assessments with 61.3 mo min f/u (n = 1073), median (95% CI) OS
was longer in those with high vs low (relative to the median) baseline
scores, regardless of tx (N + I: 19.7 [16.7–23.9] vs 14.9 [12.2–18.1] mo;
C: 17.8 [15.0–19.8] vs 10.1 [7.8–12.2] mo). OS by response/tumor burden
reduction in additional categories and updated 6-y HRQoL data will be
presented. No new safety signals were noted.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts130
Discussion: is 6-y update represents the longest f/u across 1L immuno-
therapy trials in mNSCLC.
Conclusion: N + I continued to show long-term durable ecacy benet
vs C in pts with tumor PD-L1 ≥1% or <1% (a population with high unmet
need). Responders with higher tumor burden reduction had greater long-
term OS benet with N + I vs C. Better baseline HRQoL was also associ-
ated with improved OS.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
576
Patients’ perspective on tolerability of dostarlimab in NSCLC:
patient-reported outcomes from the Phase II PERLA trial
Martin Reck1; Ana Laura Ortega Granados2; Filippo de Marinis3; Qin Shen4;
Susan Boklage4; Christine Dabrowski4; Lillian Cho4; Oren Meyers4;
Frank Griesinger5
1Lungen Clinic, Airway Research Center North, Center for Lung Research,
Grosshansdorf, Grosshansdorf, Deutschland
2Hospital Universitario de Jaén, Servicio de Oncología Médica, Español, Spanien
3European Institute of Oncology, Milan, Italien
4GSK, Collegeville, PA, USA
5Klinik für Hämatologie und Onkologie, Universitätsklinik für Innere Medizin –
Onkologie, Pius-Hospital, Oldenburg, Deutschland
Background: In PERLA trial (NCT04581824), dostarlimab+chemo-
therapy (DCT) showed similar ecacy to pembrolizumab+CT (PCT)
as rst-line treatment (Tx) for patients (pts) with metastatic non-onco-
gene-driven, non-squamous, non-small cell lung cancer (NSCLC); the
proportion of pts experiencing Tx-related adverse events or AEs leading to
Tx discontinuation was similar between groups [1]. Exploratory analyses
of pt-reported measures of tolerability were conducted.
Methods: Pts (ECOG 0–1) were randomized 1:1 to ≤35 cycles (C) of DCT/
PCT every 3 weeks (Q3W) (CT: ≤35 C of 500 mg/m2 pemetrexed + ≤4
C of cisplatin/carboplatin). Patient-reported outcome version of CTCAE
(PRO-CTCAE) and tolerability item of FACT-G (FACT-GP5) were col-
lected at Day 1 C1, then Q3W to W12, Q9W to W48, Q12W to end of Tx,
at end of Tx, and 30-day safety follow-up.
Results: Completion rates for PRO-CTCAE (DCT N=96/PCT N=88) and
FACT-GP5 (DCT N=95/PCT N=87) were >80% up to C4, then reduced
in both arms. At baseline (BL), only the urinate frequently item had >10%
of pts reporting occurrence as “frequently” or greater per PRO-CTCAE
(DCT: 11.5%; PCT: 10.2%); “severe” or greater severity and “quite a bit”
or greater interference responses were reported in <10% of pts. At C13
(~1 yr of Tx) urinate frequently was similar between arms (“frequently”
or greater in DCT: 12.5%; PCT: 10%). Relative to BL, at C13 muscle and
joint ache frequency, severity and interference responses of “quite a bit
or greater were increased in both arms, but occurred in <16% of pts. Per
FACT-GP5, at BL 85.3/94.3% of DCT/PCT pts were “not at all” or “a little
bit” bothered by Tx side eects; at C13 this was 77.4/84.2% and no pts in
either arm were “very much” bothered.
Conclusion: Most pts reported little/no bother from Tx side eects and
responses were similar across Tx arms, suggesting Tx are tolerable from pt
perspective. ese results supplement previous PERLA data and support
further investigation of dostarlimab plus existing and novel Tx in meta-
static NSCLC.
Indication of source:
1. Peters S, et al. 2022; Oral; ESMO-IO (7–9 Dec, Geneva).
Disclosure Statement: e authors declare the following: Abbvie, Amgen, Ariad,
AstraZeneca, Beigene, BMS, Bristol Myers-Squibb, Boehringer-Ingelheim, Celgene,
Daiichi-Sankyo, GSK, Janssen Lilly, LLC, Merck, MSD, Novartis, Pzer, Regeneron,
Roche, Samsung.
632
Prospective observational study of advanced lung cancer
patients treated with a combination of pembrolizumab and
Viscum album L. extract (PHOENIX-III)
Klaudia Kunc1; Marcus Reif2; Ulrike Weissenstein3; Claudia Leichnitz4;
Timo Weiß4; Katarzyna Blazejczyk4; Hannah Wüstefeld4; Harald Matthes4;
Christian Grah4
1Vivantes Humboldt-Klinikum, Berlin, Deutschland
2Gesellschaft für Klinische Forschung e.V., Berlin, Deutschland
3Verein für Krebsforschung e.V., Arlesheim, Schweiz
4Gemeinschaftskrankenhaus Havelhöhe Klinik für Anthroposophische Medizin,
Berlin, Deutschland
Background: First data suggest a benecial eect of add-on treatment
with Viscum album extract (VA) in advanced lung cancer patients. e
primary objective of this study was to evaluate the safety prole and e-
cacy of the combination therapy of immune checkpoint inhibitor pem-
brolizumab and VA (PVA) in patients with advanced non-small cell lung
cancer (NSCLC).
Methods: A prospective longitudinal observational study was conducted
with metastatic, unresectable NSCLC, Eastern Cooperative Oncology
Group (ECOG) performance status 0-2, and PVA combination therapy.
Adverse events (AEs), Trial Outcome Index (TOI) of the Functional
Assessment of Cancer erapy-Lung questionnaire, tumor response, qual-
ity of life, and survival were followed and evaluated for at least six months
and analyzed with descriptive statistics.
Result: 103 patients with advanced NSCLC treated at a German lung can-
cer center were enrolled in the study between 2017-2021 in a sub-analysis,
43 NSCLC patients with programmed death ligand 1(PD-L1) expression
>50% (mean age = 69 years, 98% Caucasian, 56% male, 81% non-squa-
mous, 14% ECOG:2, 37% smokers) rst-line treated with PVA were evalu-
ated. e median duration of PVA therapy was 6.0 months. A total of 133
AEs of any grade were observed in 39 (91%) patients during treatment,
including 25 serious AEs in 19 (45%) patients. A total of 25 immune-
related adverse drug reactions (iADRs) were identied in 15 patients
(35%), with 22 iADRs causally related to pembrolizumab and three to VA.
Four patients (9%) discontinued treatment due to ADR. e mean TOI
(±SD) of the 43 patients was 49 (± 17) at baseline, 57 (± 18) at 3 months,
and 55 (± 14) at 6 months.
Discussion: ICIs provide clinical benets in advanced cancers, but usually
they are associated with a remarkable spectrum of iADRs. ADR- and dis-
continuation rates in the PHOENIX-III cohort will be compared to rates
reported in the literature for pembrolizumab monotherapy.
Conclusion: Further studies to evaluate the clinical ecacy, safety and
management of iADRs on combination therapy should be pursued in
larger study cohorts.
Disclosure Statement: e authors declare the following: wirtschalich.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 131
636
Treatment patterns in patients with stage III NSCLC: Results
from the regional cancer registry Baden-Wuerttemberg
Bernd Mühling1; Pengfei Xu1; Julia Häberlin2,2; Franziska Kanz2;
Eugen Tausch3; Cornelia Kropf-Sanchen3; Anna Babiak3; Christina Babiak1
1Klinik für Herz-, Thorax- und Gefäßchirurgie, Uniklinik Ulm
Ulm, Deutschland
2Klinische Landesregisterstelle des Krebsregisters Baden-Württemberg,
Stuttgart, Deutschland
3Comprehensive Cancer Center Ulm, Ulm, Deutschland
Background: erapy of locally advanced lung cancer in UICC stage III
is multimodal. e aim of our study was to assess treatment patterns in
those patients in south west Germany and to evaluate whether multimodal
treatment is realized throughout the region.
Methods: Retrospective analysis of patients with stage III NSCLC in terms
of primary treatment and overall survival. As for primary treatment all
patients treated between 2015 bis 2021 were considered, as for overall sur-
vival the time frame from 2015 to 2018 was studied.
Result: Between 2015 and 2021 a total of 42.557 patients were diag-
nosed lung cancer in Baden-Wuerttemberg. Of these 6784 patients were
included for descriptive analysis, 5.444 for survival analysis. In 22%
(1479/6784) no information about primary treatment was available. In
registered patients single therapy (surgery alone, chemotherapy alone
or radiotherapy alone) was performed in 44% (2351/5305), multimodal
treatment (incl. surgery, radio- chemotherapy, immunotherapy) in 56%
(2954/5305). Median overall survival for stages IIIA, IIIB and IIIC was
26.2 vs. 17.5 vs. 10.5. months. Adenocarcinomas showed signicantly
better survival in men and in women.
Discussion: Although recording of patients in regional cancer registries
is not obligatory our data analysis demonstrates for the rst time real-
world treatment patterns in patients with stage III NSCLC in southwest
Germany.
Conclusion: Despite clear guidelines multimodal treatment of patients
with NSCLC UICC III is not satisfactorily realized. It is not clear why
a huge proportion of patients does not receive multimodal treatment
approaches. However results might be biased as there is no obligation for
registering patients in cancer registries.
Disclosure Statement: e authors declare no conict of interest.
674
Tumor Treating Fields (TTFields) therapy with standard
systemic therapy in metastatic non-small cell lung cancer
following progression on or after platinum-based therapy:
global, randomized, pivotal (phase 3) LUNAR study
Richard Greil1; Ticiana Leal2; Rupesh Kotecha3; Rodryg Ramlau4; LI Zhang5;
Janusz Milanowski6; Manuel Cobo7; Jaromir Roubec8; Lubos Petruzelka9;
Libor Havel10; Jerey Ward11; Sujith Kalmadi12; Zoran Andric13;
Thierry Berghmans14; David Gerber15; Goetz Kloecker16; Rajiv Panikkar17;
Joachim Aerts18; Angelo Delmonte19; Miklos Pless20; Christian Rolfo21;
Wallace Akerley22; Michael Eaton23; Mussawar Iqbal24; Corey Langer25
1Salzburg Cancer Research Institute-Center for Clinical Cancer and Immunology
Trials (SCRI-CCCIT); Paracelsus Medical University Salzburg; Cancer Cluster,
Salzburg, Österreich
2Winship Cancer Institute at Emory University, Atlanta, USA
3Miami Cancer Institute, Baptist Health South Florida, Miami, USA
4Poznan University of Medical Sciences, Poznan, Polen
5Sun Yat-sen University Cancer Center (SYSUCC), Guangzhou, China, VR
6Medical University of Lublin, Lublin, Polen
7Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria
University Hospitals, IBIMA, Malaga, Spanien
8Nemocnice AGEL Ostrava-Vítkovice, Ostrava, Tschechische Republik
9General University Hospital in Prague, Prague, Tschechische Republik
10Thomayer Hospital, Prague, Tschechische Republik
11Washington University School of Medicine, St. Louis, USA
12Ironwood Cancer & Research Centers, Chandler, USA
13Clinical Hospital Centre Bezanijska Kosa, Belgrade, Serbia
14Jules Bordet Institute, Hôpitaux Universitaires de Bruxelles, Université Libre de
Bruxelles, Brussels, Belgien
15Harold C. Simmons Comprehensive Cancer Center, UT Texas Southwestern
Medical Center, Dallas, USA
16University of Louisville, Louisville, USA
17Geisinger Cancer Institute, Danville, USA
18The Erasmus MC Cancer Institute, Erasmus University Medical Center,
Rotterdam, Niederlande
19IRCCS Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori” (IRST),
Meldola, Italien
20Kantonsspital Winterthur, Winterthur, Schweiz
21Center for Thoracic Oncology, Tisch Cancer Institute at Icahn School of
Medicine, Mount Sinai, USA
22Huntsman Cancer Institute, University of Utah, Salt Lake City, USA
23St Francis Hospital, Indianapolis, USA
24College of Medicine, University of Saskatchewan, Saskatoon, Kanada
25Abramson Cancer Center, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, USA
Background: TTFields are electric elds that disrupt cancer cell viabil-
ity. TTFields therapy is approved for glioblastoma and mesothelioma. e
randomized, pivotal (phase 3) LUNAR study (NCT02973789) assessed the
ecacy and safety of TTFields therapy with investigators choice of stand-
ard systemic therapy (ST; immune checkpoint inhibitor [ICI] or docetaxel
[DTX], standard of care at time of study design) for metastatic non-small
cell lung cancer (mNSCLC) progressing on/aer platinum-based therapy.
Methods: Adult patients were randomized 1:1 to TTFields+ST or ST.
Primary endpoint: overall survival (OS); key secondary endpoints: OS in
ICI and DTX subgroups; other secondary endpoints: adverse events (AEs)
and patient-reported HRQoL assessed from baseline to 54 weeks by the
validated EORTC QLQ-C30 questionnaire.
Result: 276 patients (TTFields+ST, n=137; ST, n=139) were included.
Median (m) age was 64 years (range, 22–86), 64% were male, 57% had
non-squamous NSCLC, 96% had ECOG PS 0–1, 10% had >1 prior line
of ST, and 32% had prior ICI. Characteristics were balanced between
arms. OS was signicantly extended with TTFields+ST vs ST: mOS
(95% CI) 13.2 (10.3–15.5) vs 9.9 (8.1–11.5) months (mo); HR 0.74 (95%
CI 0.56–0.98); P=0.035. In the ICI subgroup (n=134), TTFields therapy
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts132
signicantly improved OS vs ICI alone: mOS (95% CI) 18.5 (10.6–30.3)
vs 10.8 (8.2–18.4) mo; HR 0.63 (95% CI 0.41–0.96); P=0.030. In the DTX
subgroup (n=142), mOS (95% CI) with TTFields+DTX vs DTX was 11.1
(8.2–14.1) vs 8.7 (6.3–11.3) mo; HR 0.81 (95% CI 0.55–1.19); P=0.28.
AEs were similar for TTFields+ST (97%) vs ST (91%). 71% reported a
device-related AE; 6% were grade 3. For global health status, there was no
clinically meaningful (≥10 points) decline in either treatment group, or
dierence between treatment groups.
Discussion: TTFields therapy plus ST extended OS vs ST without exacer-
bating systemic toxicities or adversely aecting HRQoL in patients with
mNSCLC progressing on/aer platinum-based therapy.
Conclusion: ese results warrant TTFields therapy as an option to man-
age mNSCLC in this setting.
Disclosure Statement: e authors declare that there are conicts of interest.
econicts were submitted to the congress organizer KUKM GmbH and KUKM
can disclose them if needed.
685
Concordance on treatment recommendations from
multidisciplinary tumor boards – Data from driver-mutated
lung cancer patients in focus
Julia Roeper1; Jan Wagner2; Frank Griesinger1
1Universität Oldenburg/Pius Hospital, Oldenburg, Deutschland
2UKE Hamburg, Hamburg, Deutschland
Background: Multidisciplinary tumor boards (MTB) aim at developing
the best possible treatment plan according to guidelines of national med-
ical societies while considering the individual patients case. For this pur-
pose, every patient should be discussed in a MTB. e aims of the study
were to investigate the frequency of dierent degrees of concordance (full,
partial, non-concordance), the potential dierence in concordance in
driver-mutated patients and the overall survival associated with dierent
degrees of concordance.
Methods: Data from 644 patients with lung cancer discussed in tumor
boards were documented and evaluated according to the concordance on
MTB recommendations. 75/644 (12%) of these patients showed a driver
mutation. Clinical characteristics were compared using Fischer’s chi-square,
t-test, or exact test. Correlations between concordance rate and overall sur-
vival were exploratory using Kaplan-Meier survival analyses. Multilevel
analysis and Cox regression models will be presented at the conference.
Result: e overall concordance rate was 85% (545/644). Patients with a
driver mutation (n=53 patients with an EGFR 19/21 mt; n=15 patients
with an EML4 ALK translocation; n=9 patients with a BRAF mt; n=2
patients with a ROS1 mt) had a concordance rate of 91% (69/75) com-
pared to 85% concordance rate of the overall cohort. Patients with a com-
plete concordance to the MTB recommendation had an OS of 17 months
(n=545) compared to 4 months (n=99) for patients with a discordant
treatment (p<0.001). e driver-mutated concordant treated patients had
a longer OS of 21 months vs. 2 months for patients with a discordant treat-
ment (p<0.001).
Conclusion: Patients with a concordant treatment had a signicant lon-
ger OS as patients with a discordant treatment. e concordance rate
was higher in the group of driver-mutated patients and patients with a
driver-mutation and a concordant treatment showed a longer OS as
patients without. Assessment of concordance to MTB recommendations
could become a meaningful and reproducible quality criterion for cancer
centers in Germany.
Disclosure Statement: e authors declare the following: Präsentationshonorar
AstraZenca, BoehringerIngelheim.
689
First-line (1L) nivolumab (N) plus ipilimumab (I) with two
cycles of chemotherapy (chemo) in patients with metastatic
non-small cell lung cancer (mNSCLC): Results from an interim
analysis of the non-interventional FINN study
Jonas Kuon1; Eyck von der Heyde2; Marina Bischo3; Stefan Wilop4;
Dirk Behringer5; Wolfgang Blau6; Gerdt Hübner7; Dimitri Flieger8;
Helmut Forstbauer9; Matthias Groschek10; Heinz-Eckart Laack11;
Harald Müller-Huesmann12; Christian Schumann13;
Daniela Waldenberger14; Sylvia Gütz15
1SLK Fachklinik Löwenstein, Lowenstein, Deutschland
2Onkologie am Raschplatz, Hannover, Deutschland
3Klinikum Idar-Oberstein GmbH, Idar-Oberstein, Deutschland
4MVZ West GmbH Würselen, Würselen, Deutschland
5Augusta Kranken Anstalt gGmbH, Bochum, Deutschland
6Helios Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Deutschland
7ohO-ostholstein Onkologie, Oldenburg in Holstein, Deutschland
8GPR Klinikum Rüsselsheim, Rüsselsheim, Deutschland
9GOSPL Gesellschaft für onkologische Studien, Praxismanagement und Logistik,
Troisdorf, Deutschland
10Clinical Research Stolberg GmbH, Stolberg, Deutschland
11Studiengesellschaft Hämato-Onkologie Hamburg, Hamburg, Deutschland
12Klinik für Hämatologie und Onkologie, Brüderkrankenhaus St. Josef Paderborn,
Paderborn, Deutschland
13Klinikverbund Allgaeu gGmbH, Kempten and Immenstadt, Deutschland
14Bristol Myers Squibb Deutschland, München, Deutschland
15St. Elisabeth-Krankenhaus Leipzig, Leipzig, Deutschland
Background: e CheckMate 9LA study showed that N + I with 2 cycles
of chemo vs chemo alone signicantly improved overall survival (OS) for
patients (pts) with mNSCLC. e FINN real-world study (NCT04794010)
aims to evaluate this regimen in clinical practice in Germany.
Methods: Enrollment for the prospective, observational study is ongoing,
with 90 sites and 650 pts planned in Germany. Pts ≥18 y old with mNSCLC
are eligible if they began 1L N + I with 2 cycles of chemo per the approved
EMA label. During the planned ≤5-y follow-up period (from treatment
[tx] initiation until death, withdrawal of consent, loss of follow-up, or end
of study), assessments will be conducted per routine local clinical prac-
tice. e primary endpoint is OS. Secondary endpoints include progres-
sion-free survival, tx duration, patient characteristics, and safety.
Result: At the interim analysis (Jan 31, 2023), 256 pts were enrolled
(median follow-up: 5.6 mo). Median (range) age was 67 (43–86) y;
46.9%, 39.8%, and 12.9% of pts were <66, 66–75, and >75 y old, respec-
tively. Most pts were male (60.9%), current/former smokers (81.6%),
had an ECOG performance status of 0 or 1 (84.4%), and had non-squa-
mous tumor histology (63.7%). e median number of metastases was 2
(range, 0–12). Most pts (67.6%) had extrathoracic metastases (M1b/M1c
disease) with brain and liver metastases in 19.9% and 19.1%, respectively.
Few pts had received prior therapy, including radiotherapy (18.8%), sur-
gery (17.2%), or systemic therapy/chemo (12.9%). Tx-related adverse
events (AEs) of all grades occurred in 53.9% of pts, and tx-related
severe AEs occurred in 17.6% of pts. ere was 1 tx-related death from
immune-mediated hepatitis. We will present updated data with longer
follow-up (data cuto July 2023).
Discussion: is study will provide valuable real-world insights on tx with
N + I with 2 cycles of chemo in mNSCLC.
Conclusion: e FINN study will describe patient characteristics, ecacy,
safety prole, and tx patterns of 1L N + I with 2 cycles of chemo in clini-
cal practice in Germany. At interim analysis, pts had a manageable safety
prole.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 133
700
Increasing liquid biopsy sensitivity to the next level: usability
of minimal residual disease detection by longitudinal
genomic fusion tracing using specic digital droplet PCR
(ddPCR) in non-small cell lung cancer (NSCLC) treated with
immune checkpoint inhibition (ICI) +/- chemotherapy
Frank Griesinger1; Julia Roeper1; Tobias Overbeck2; Kay Willborn3; Philipp
Ströbel2; Thomas Asendorf2; Jessica Halfen2; Heiko Golpon4; Ekke Schütz5;
Srushti Borkar1; Fenja Markus6; C. Vössing6; P. Weist6; Lukas Heukamp6
1Universität Oldenburg/Pius Hospital, Oldenburg, Deutschland
2UMG Göttingen, Göttingen, Deutschland
3Pius Hospital, Oldenburg, Deutschland
4MHH Hannover, Hannover, Deutschland
5GmbH an Oncocyte Company, Göttingen, Deutschland
6Lungenkrebsmedizin Oldenburg GbR, Oldenburg, Deutschland
Background: erapy monitoring in NSCLC has the potential to inform
optimal therapy in the metastatic and the non-metastatic curative setting.
It has been shown in many studies, that drop of detection of ctDNA is
associated with a better prognosis in patients treated with ICI and also in
driver mt+ positive tumors. In the non-metastatic setting, the presence
of residual disease aer surgery, induction therapy or radio-chemother-
apy could potentially be used to decide on further interventions such as
adjuvant therapy, escalation of therapy or maintenance therapy, respec-
tively. However, in most cases in the non-metastatic setting, detection of
ctDNA is hampered by limited sensitivity of ctDNA assays. Recently it
has been shown in neuroblastoma, that genomic breakpoints of frequent
somatic chromosomal rearrangement can be used to generate tumor spe-
cic ddPCR assays for minimal residual disease (MRD) detection. As
NSCLC is routinely comprehensively analyzed for mutations and fusions,
in more than 90% of NSCLC specic non-druggable fusions are detected
by hybrid capture assays.
Methods: erefore, we plan to investigate the usability of generating
breakpoint specic ddPCR primers in 40 NSCLC IV pts treated in the
palliative setting with ICI +/- chemotherapy: ddPCR primers are derived
from tumor specic genomic breakpoints and will be tested at 3 dierent
time points during the course of 1st line treatment, i.e. prior to systemic
therapy, at 6 and 9 weeks on therapy and at progression. Correlation of
ddPCR MRD monitoring results will be done for ORR, PFS and OS within
the eraSure CNI-Monitor Trial conducted by the CCC-N. Trial start to
recruit in August 2023.
Result: Clinical characteristics of the pts, Kaplan-Meier survival analyses
and Cox regression models will be presented at the conference.
Conclusion: Establishing a minimally invasive, low-cost diagnostic proce-
dure to detect and monitor MRD has the potential to provide a more com-
prehensive view of the risk of relapse in pts, allowing clinicians to adapt
treatment approaches earlier, with the goal of improving cancer survival.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
739
Genetic expression and prognostic impact of PIK3CA-gene
mutations (exon 9 and exon 20) in patients with stage IV
non-small cell lung cancer (NSCLC)
Darko Katalinic1; Ivan Aleric1; Aleksandar Vcev1; Lars Toetome2
1Faculty of Dental medicine and Health and Faculty of Medicine, University of
Osijek, Osijek, Kroatien
2Center for Cancer Medicine, Oslo, Norwegen
Background: e phosphatidylinositol 3-kinase (PI3K) plays an important
role in cell proliferation. It consists of a regulatory and a catalytic subu-
nit; the latter one is encoded by 3 genes including PIK3CA, PIK3CB, and
PIK3CD. e PIK3CA mutations are the most frequent in cancers. In non-
small cell lung cancer (NSCLC), mutations withinPIK3CAdomain usu-
ally aect the helical binding (exon 9) or the catalytic domain (exon 20),
and they are considered oncogenic. e aim of our study was to assess the
frequency and signicance of PIK3CA mutations (exon 9 and exon 20)
among the patients with NSCLC and to compare the data to clinicopatho-
logical and molecular features.
Methods: e study was performed among 270 patients (62.4% males and
37.6% females; mean age of 54.47 ± 16.37 years) with diagnosis of stage IV
NSCLC. Tumor tissue was analyzed forPIK3CA, BRAF and KRAS muta-
tions using quantitative real-time polymerase chain reaction restriction
fragment length polymorphism assay.
Result: We identied 11 (4.1%) patients withPIK3CAmutations in exon
9 and exon 20. ese mutations were found with a higher frequency in
sqamous cell carcinoma (11.7%) compared to adenocarcinoma (3.1%,
p<0.001). e most commonPIK3CAmutation was exon 9 E545K and it
was related to poor progression-free survival (PFS) (P= 0.021) and poor
cancer-specic survival (CSS) (P= 0.005). No correlation to overall sur-
vival (OS) was observed (P= 0.006). ere was strong correlation between
PIK3CA and BRAF and KRAS mutational status (P = 0.001).
Discussion: Our study showed that PIK3CA (exon 9 and exon 20) muta-
tion rate is in accordance with previously published data. Furthermore,
the PIK3CA (exon 9 and exon 20) mutational status was an independent
risk factor for PFS and CSS of patients with NSCLC and was in strong
correlation with BRAF and KRAS mutational status.
Conclusion: e poor prognosis of patients with singlePIK3CAmutation
in NSCLC and the prognostic value ofPIK3CA, KRAS and BRAFmuta-
tions should be determined for individual therapeutic strategies in
NSCLC.
Disclosure Statement: e authors declare no conict of interest.
755
Addressing systemic rst line therapy of elderly lung cancer
patients is critical
Konstantinos Ferentinos1; Jan Volmerig2; Georg Nilius3; Birgit Jaeger4;
Andreas Koziorowski5; Imke Stoever5; Daniel Christoph1
1Department of Medical Oncology and Oncological Palliative Care, Evang.
Kliniken Essen-Mitte, Essen, Deutschland
2Department of Thoracic Surgery, Evang. Kliniken Essen-Mitte, Essen,
Deutschland
3Department of Pneumology, Evang. Kliniken Essen-Mitte, Essen, Deutschland
4MVZ Strahlentherapie, Alfried-Krupp-Krankenhaus Essen, Essen, Deutschland
5Strahlentherapie Ruhr, Essen, Deutschland
Background: At the time of diagnosis, the majority of the lung cancer
(LC) patients (pts) are old and have comorbidities. ey are underrepre-
sented in clinical trials and have limited therapy options.
Methods: In our retrospective data analysis we included all pts older than
75 years with LC regardless of stage treated at a DKG-certied LC cen-
tre and primary LC diagnosis from 2017 until 2022. Progression-free and
overall survival, objective response rate, and adverse events (AEs) result-
ing in therapy discontinuation were assessed for pts with systemic therapy.
Results: 365 out of all 1.837 newly diagnosed LC pts from 2017 to 2022
were older than 75 years. Of these, 115 pts (31.5%) underwent primary
surgery and 15 pts (4.1%) primary radiotherapy; 143 pts (39.2%) received
systemic treatment and 92 pts (25.2%) had best supportive care. 43 pts
(11.8%) suered from small cell LC and 322 pts (88.2%) from non-small
cell LC. 99 pts with systemic therapy (69.2%) received combined chemo-/
immunotherapy, 31 pts (21.7%) immunomonotherapy and 13 pts (9.1%)
a small molecule inhibitor. 22 pts with systemic therapy (15.4%) had an
ECOG performance status (PS) of 0, 80 pts (56 %) a PS of 1, 36 pts (25.1%)
a PS of 2 and 5 pts (3.5%) a PS of 3. All elderly pts with high PD-L1
expressing tumours received immunomonotherapy. 89 of 99 pts (90%)
with chemo-/immunotherapy received platinum-based chemotherapy. Of
these, 30 pts (30%) had to stop therapy prematurely due to AEs.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts134
Discussion: For pts whose tumour expresses lower levels of PD-L1 (TPS
<50% or ICS <10%) combined platinum-based chemo-/immunotherapy
is the recommended rst line therapy, but elderly pts are usually unt to
get these therapies at the regular dosage. A single-agent immunotherapy
might be eective in some cases but is only approved for pts with high
PD-L1 expressing tumours (TPS ≥50% or ICS ≥10%).
Conclusion: Many elderly pts received combined chemo-/immunother-
apy, but therapy was oen prematurely stopped due to AEs. A quarter of
the pts with systemic therapy had a PS of 2.
Disclosure Statement: e authors declare the following: Beratungstätigkeit/
Honorare: Boehringer, Glaxo, Berlin Chemie, AstraZeneca, Bayer, Boehringer-
Ingelheim, Bristol-Myers Squibb, Chugai, MSD Merck, Sharp & Dohme, Novartis,
Novocure, Pzer, Roche, Sano, Takeda.
885
Prognostic biomarkers improve selection of SCLC patients for
second line treatment with Topotecan
Laura Lambrecht; Toki Bolt; Jürgen Behr; Amanda Tufman;
Diego Kaumann-Guerrero
LMU Klinikum München, München, Deutschland
Background: SCLC is a highly aggressive tumor and overall survival (OS)
remains poor despite intensive eorts to develop new treatment strategies.
Especially in second line topotecan is the only approved drug with a mOS
of 5.9 month. However, real-world SCLC patients are oen in worse con-
dition and harbor more comorbidities than study populations. erefore,
the real world performance of, topotecan may dier from that seen in
studies. Here, we analyzed outcomes of SCLC patients receiving topotecan
and identied predictive and prognostic markers.
Methods: We retrospectively analyzed 44 SCLC patients receiving topo-
tecan between 2015 and 2022. We analyzed baseline characteristics (age,
ECOG-PS, topotecan cycles and dosage) and pre-treatment blood values
(LDH, CRP, sodium) as well as prognostic scores (neutrophil/lymphocyte
ratio (NLR), thrombocyte/lymphocyte ratio, Glasgow Prognostic Score,
prognostic nutritional score, systemic inammation index (SII) and the
prognostic index) extracted from electronic patients’ charts to identify
prognostic markers.
Result: mPFS and mOS was 1.9 and 5.6 months respectively in the whole
cohort. ECOG-PS (p>0.001), NLR (p=0.001) and SII (p=0.008) were sig-
nicant independent prognostic variables in a multivariate COX regres-
sion model. Selecting patients by these three markers achieved a mPFS
of 5.7 and thus increased the mPFS 3-fold in comparison to the whole
cohort. Patients not meeting all criteria had a PFS of 1.8 months (p=0.006).
Patients identied by prognostic markers had a mOS of 8.1 months.
Discussion: e ecacy of topotecan in SCLC real-world patients is very
poor indicating that many patients were treated without any benet. Easy
to obtain markers can predict response and treatment ecacy and should
therefore be validated in larger cohorts to identify patients more probable
to benet from topotecan.
Conclusion: Due to the limited ecacy and high potential for side eects,
the selection of SCLC patients for second-line topotecan treatment might
be guided by easy to obtain markers.
Disclosure Statement: e authors declare no conict of interest.
893
Benchmark of screening markers for KEAP1/NFE2L2
mutations and joint analysis with the K1N2-score
Christoph Arolt1; Andreas Calaminus1; Margaret Dugan2; Robert Wild2;
Vanessa Richartz1; Barbara Holz1; Johannes Brägelmann1,3,4,5; Svenja
Wagener-Ryczek1; Sabine Merkelbach-Bruse1,6; Jürgen Wolf6,7; Reinhard
Büttner1,6; Luigi Catanzariti2; Matthias Scheer6,7; Axel Hillmer1,3
1Institute of Pathology, University of Cologne, Faculty of Medicine and
University Hospital Cologne, Köln, Deutschland
2Dracen Pharmaceuticals Inc., San Diego, CA, USA
3Center for Molecular Medicine Cologne, University of Cologne, Köln,
Deutschland
4Mildred Scheel School of Oncology, University of Cologne, Faculty of Medicine
and University Hospital Cologne, Köln, Deutschland
5Department of Translational Genomics, University of Cologne, Faculty of
Medicine and University Hospital Cologne, Köln, Deutschland
6Lung Cancer Group Cologne, Center for Integrated Oncology Cologne/Bonn,
University Hospital Cologne, Köln, Deutschland
7Department I for Internal Medicine, Center for Integrated Oncology Cologne/
Bonn, University Hospital Cologne, Köln, Deutschland
Background: Non-small-cell lung cancer (NSCLC) with KEAP1/NFE2L2-
pathway activation is a distinct NSCLC group characterized by poor clin-
ical outcome. We recently developed a unifying transcriptomic signature
(K1N2-score) that robustly detects pathway activation status and KEAP1/
NFE2L2 mutation status allowing for potential patient selection in a pre-
cision medicine setting. As the clinical availability of multi-gene RNA
sequencing might be limited, we evaluated NQO1 immunohistochemis-
try (IHC) and RNA expression data of single genes as potentially more
accessible screening approaches.
Methods: mRNA of 348 in-house FFPE samples were quantied with a
custom NanoString mRNA panel. 232 of these tumors were analyzed with
NQO1 IHC and scored. mRNA Expression of the top ve K1N2-Score
genes and NQO1, as well as NQO1 IHC were evaluated to predict the
KEAP1/NFE2L2 mutation status. Using a validation dataset (mRNA =
108; IHC n = 89), all markers were tested alone or as a screening marker,
which, if positive, was followed by validation with the K1N2-score.
Result: While NQO1-IHC alone predicted the mutation status with a
moderate Youdens J of 0.33 (sensitivity + specicity -1), the predictive
power was increased through K1N2-score validation (J = 0.69, Sens =
0.84, spec = 0.85) and was similar to the K1N2-score alone (J = 0.73, sens:
0.9, spec: 0.83). Both tests were outperformed by the combination of either
of NQO1, TRIM16 or TXNRD1 RNA with the K1N2-Score (J = 0.75, 0.74
and 0.73, respectively).
Discussion: Combined testing of NQO1 IHC and the K1N2-score had
a comparable performance as the K1N2 score alone when predicting
KEAP1/NFE2L2 mutations status. is approach required 23 less (- 26%)
K1N2-score analyses while adding the cost of 89 IHC. However, the com-
bined testing of NQO1 mRNA and the K1N2-score outperformed all
other approaches.
Conclusion: Combination of NQO1 IHC with the K1N2-Score is a feasi-
ble, potentially more cost-ecient test strategy than the K1N2 score alone.
However, quantitative NQO1 mRNA testing should be evaluated as alter-
native screening test in clinical samples.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 135
899
Development and validation of a brief questionnaire to assess
lung cancer-specic health competence (gesa-NSCLC)
Thomas Elter1,2; Carolin Groß-Opho-Müller2,3; David Hoier2,4;
Andreas Greeske2; Jonas Heidelbach2; Heinz-Wilhelm Esser2;
Michael Hallek1; Marcus Redaèlli5; Christopher Kofahl6
1University of Cologne, Department I of Internal Medicine, Center for Integrated
Oncology Aachen Bonn Cologne Duesseldorf, Cologne, Deutschland
2Onqo Health GmbH, Cologne, Deutschland
3Kliniken der Stadt Köln gGmbH, Cologne, Deutschland
4St. Martinus Krankenhaus, Duesseldorf, Deutschland
5Institut für Gesundheitsökonomie und Klinische Epidemiologie, Uniklinik Köln,
Cologne, Deutschland
6Zentrum für Psychosoziale Medizin, Institut für Medizinische Soziologie,
Universitätsklinikum Hamburg-Eppendorf, Hamburg-Eppendorf, Deutschland
Purpose: One third of lung cancer patients do not receive the best stand-
ard of care. Besides guideline-concordant treatment, adequate health lit-
eracy is a key criterion for optimal outcome. An established instrument
for assessing cancer-specic health literacy is the gesa-k questionnaire
and the Brief Generic Cancer Knowledge Scale (BCKS-10) that based on
it. However, no brief questionnaire is available to specically assess health
literacy in lung cancer patients.
Methods: In order to better reect the reality of care for lung can-
cer patients, we specied two questions of BCKS-10 for developing the
gesa-NSCLC questionnaire. A rst data analysis of 355 healthy individuals
that participated in an online survey served for validation.
A second analysis compared both results of the gesa-NSCLC (healthy
population) with BCKS-10 (cancer patients) to dene the treatment-
related increase of cancer-specic health literacy.
Results: Final questionnaire consists of 10 questions. In terms of item dis-
crimination, the corrected item-total correlation of 8 out of 10 items were
above the threshold of 0.3. Cronbachs alpha of about 0.68 revealed an
acceptable internal consistency as the tool is brief and consists of dierent
dimensions.
Discussion: Since people with cancer have to deal with very specic infor-
mation on diagnosis and therapy, more specic survey instruments are
consequently necessary. However, no brief questionnaire exists to date
that can measure lung cancer-specic health literacy. e gesa-NSCLC
questionnaire was developed to enable an even more specic survey of
health literacy in people with lung cancer.
Conclusion: We developed and validated the rst brief health literacy
questionnaire gesa-NSCLC designed specically for patients with lung
cancer.
Disclosure Statement: The authors declare the following: Thomas Elter is
founder and CEO of Onqo Health GmbH Carolin Groß-Ophoff-Müller is a
research assistant at Onqo Health GmbH David Hoier is a research associate at
Onqo Health GmbH, Jonas Heidelbach is CMO and Adreas Greeske the CTO
of Onqo Health.
914
Clinical applications of circulating tumor cells in non-small cell
lung cancer
Varun Gupta1; Ka-Won Noh2
1Lungenklinik Hemer Abteilung für Thoraxchirurgie, Hemer, Deutschland
2Pathologie Uniklinik Köln, Köln, Deutschland
Despite curative treatment, around 30–55% of NSCLC patients relapse,
primarily at distant sites, and 50% succumb to lung cancer. Circulating
tumor cells (CTC) get dislodged from the primary tumor or metastatic
sites and circulate in the bloodstream.
CTC positivity was associated with poor overall survival (OS) and dis-
ease-free survival (DFS). CTC counts signicantly increase in the pulmo-
nary vein aer surgical manipulation of the tumor or even endoscopic
biopsy.
A systemic review and metaanalysis by Wankhede et al. published
Cancers in 2022, showed that CTC status was highly predictive of the
survival outcomes of patients with early-stage NSCLC. Specically,
CTC+ status had a negative impact on OS, regardless of time and source
of blood collection, detection methods, and follow-up duration. Meta-
analytic data showed that CTC status was highly predictive of the sur-
vival outcomes and had a negative impact on DFS, regardless of time and
source of blood collection, detection methods, and follow-up duration.
In addition, it was found that the pathological stage was associated with
CTC status, with stage III patients more likely to be CTC+, whereas stage
I was at a lower risk.
As the stage progressed from early to advanced, the likelihood of CTC+
increased accordingly. Stage I disease was least likely to be associated
with CTC resembling the classical view of the impact of the stage on
CTC. Moreover, CTC count correlated with the pathologic stage in a
similar way.
ese ndings hint towards the increased shedding of CTC from the
bulky tumor and multiple nodal metastases. is result also conforms to
the current evidence on the association of CTC to tumor size and lymph
node metastasis.
To conclude, CTC could be a valid prognostic indicator for OS and DFS.
Pre- and Post-OP CTC analysis can guide percision therapy. Timing of
surgery and neo-adj. or adj. therapy can be based on CTC values. CTC
could be used as a marker for recurrence survelience and response to
therapy.
Disclosure Statement: e authors declare no conict of interest.
947
Recurrence of locally advanced NSCLC after
radiochemotherapy and consolidative Durvalumab - A
german multicenter retrospective analysis
Lea Reitnauer1; Georg Evers1; Daniel Christoph2; Wolfgang Brückl3; Marcel
Wiesweg4; Franziska Glanemann4; Maximilian Webendörfer4; Cornelia
Kropf-Sanchen5; Fabian Acker6; Wolfgang Schütte7; Petra Hoknecht8;
Andrea Kerkho1; Michael Mohr1; Georg Lenz1; Nikolaj Frost9; Tobias
Overbeck10; Martin Sebastian6; Annalen Bleckmann1
1University Hospital Münster, Department of Medicine A - Hematology,
Oncology and Pneumology, Münster, Deutschland
2Kliniken Essen-Mitte, Department of Medical Oncology/Haematology, Essen,
Deutschland
3Paracelsus Medical University, General Hospital Nuremberg
3Department of Respiratory Medicine, Allergology and Sleep Medicine /
Nuremberg Lung Cancer Center, Nürnberg, Deutschland
4University Hospital Essen, University Duisburg-Essen, Department of Medical
Oncology, West German Cancer Center, Essen, Deutschland
5University of Ulm, Department of Pulmonology, Internal Medicine II, Ulm,
Deutschland
6Goethe University Frankfurt, University Hospital, Department of Hematology
and Oncology, Frankfurt/Main, Deutschland
7Martha-Maria Krankenhaus Halle-Dölau, Department of Internal Medicine II,
Halle (Saale), Deutschland
8Niels-Stensen-Kliniken Franziskus-Hospital Harderberg, Georgsmarienhütte,
Deutschland
9Charité - Universitätsmedizin Berlin (Corporate Member of Freie Universität
Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health),
Department of Infectious Diseases and Pulmonary Medicine, Berlin,
Deutschland
10University Medical Center Göttingen, Department of Hematology and Medical
Oncology, Göttingen, Deutschland
Background: Although some progress has been made in the treatment of
locally advanced non-small cell lung cancer (NSCLC), disease progres-
sion or recurrence remains common in most patients. However, to date,
there are no established standards for further therapeutic approaches in
relapsed/refractory (r/r) NSCLC. Here, we present real world data from
patients with r/r NSCLC.
Methods: Data from 122 patients from 10 German lung cancer centers
was analyzed retrospectively. e patients were treated for r/r NSCLC
aer radiochemotherapy and consolidative durvalumab between 06/2017
and 07/2023. Overall survival (OS) and progression-free survival (PFS)
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts136
were calculated for the entire patient population and compared in relation
to the salvage therapy selected.
Result: Median OS of the total cohort aer initial diagnosis of NSCLC
was 25.8 mths (95%-CI 20.6 - 30.9). Aer disease recurrence, median OS
and PFS were 11.7 (95%-CI 9.2 - 14.2) and 6.4 mths (95%-CI 5.2 - 7.6),
respectively. e majority of patients received systemic therapy (70.5%).
e choice of therapeutic agents varied between checkpoint inhibitors
(with and without chemotherapy, 34.9%), platinum-based chemotherapy
(30.2%) and single agent chemotherapy (27.9%). Few patients received
targeted therapy (7.0%). OS was higher in the group of patients who
received checkpoint inhibitor-based therapy than in the groups of patients
who received other systemic therapies (median OS 23.8 vs. 10.8 mths,
p= 0.003). Moreover, our data indicate that OS might be inuenced by
ECOG status (p <0.001) and site of recurrence (intra- vs. extrathoracic,
p = 0.003).
Discussion: r/r NSCLC is associated with a poor prognosis. Our analy-
sis suggests that continuation of immunotherapy might be benecial in
patients with r/r NSCLC. However, our data should be interpreted with
caution due to its retrospective character.
Conclusion: Prospective clinical trials are needed to optimize treatment
strategies in patients with r/r NSCLC and to identify parameters that
determine prognosis.
Disclosure Statement: e authors declare no conict of interest.
Molecular Pathology
301
WAYFIND-R: A global, real-world database of patients
(pts) with a solid tumour proled with next-generation
sequencing (NGS)
Uwe M. Martens1; Jean-Yves Blay2; Allan Hackshaw3; Christophe Le
Tourneau4; Jan Geissler5; Anna Ferro6; Erika Schirghuber6; Olga Skatkova6;
Rodrigo Dienstmann7
1SLK-Kliniken Heilbronn GmbH, Heilbronn, Deutschland
2Centre Léon Bérard, Lyon, Frankreich
3UCL Cancer Institute, London, United Kingdom
4Institut Curie, Paris, Frankreich
5Patvocates GmbH, Munich, Deutschland
6F. Homann-La Roche Ltd, Basel, Schweiz
7Vall d’Hebron Institute of Oncology, Barcelona, Spanien
Background: WAYFIND-R is a global, multicenter, prospective pan-can-
cer registry collecting long-term data from pts diagnosed with a solid
tumour proled with NGS. e goal is to advance precision medi-
cine by providing high-quality real-world data (RWD) to researchers
internationally.
Methods: WAYFIND-R data are electronically collected into a centralised
database with standardised forms and high quality data management pro-
cedures. To ensure reliability/accuracy and a t-for-purpose data source,
data are periodically evaluated. Enrolment began in Sep 2020. Sites submit
baseline pt, tumour, biomarker, NGS and molecular tumour board (MTB)
decision making at enrolment, and treatment and outcome data at routine
follow up.
Result: As of 31 Mar 2023, 855 pts had completed baseline data collec-
tion and cancer-related information; 755 carried on to the next data col-
lection, 119 had died and 18 had ended participation. Pts were enrolled
at 61 sites across 23 countries, mostly at academic institutions/university
hospitals. e median age was 65 years (range: 20–93), 50% were female,
49% were retired and 62% had government insurance. WAYFIND-R had
109 cancer types and 160 subtypes (most common: adenocarcinoma
[n = 389]). e most commonly detected genes were TP53, KRAS, EGFR,
BRAF and APC. e most commonly screened non-NGS biomarkers
were cytokeratin 7 (CK7/KRT7), PD-L1, CA19-9, CEA and Ki67. Many
pts (n = 341; 40%) had not been evaluated by an MTB. e most frequent
MTB recommendation aer NGS testing (n = 213; 25%) was to start
other treatment (chemotherapy: 63%; immunotherapy: 19%; targeted
therapies: 18%).
Conclusion: e WAYFIND-R registry captures precision oncology data
using a standardised approach globally. WAYFIND-R can enable further
insights into clinical decision making, the timeliness of NGS testing and
access to therapy.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
403
Principal-agent theory-based survey of the care and
reimbursement situation of molecular diagnostics in
non-small cell lung cancer in the German inpatient sector
Melina Sophie Kurte1,2; Ann-Cathrine Siefen2; Robert Dengler3;
Florian Kron2,4,5,6
1Faculty of Medicine, University of Duisburg-Essen, Essen, Deutschland
2VITIS Healthcare Group, Cologne, Deutschland
3OncoLogic Healthcare Consulting GbR, Nittendorf, Deutschland
4Center for Integrated Oncology (CIO ABCD), Faculty of Medicine and University
Hospital of Cologne, University of Cologne, Cologne, Deutschland
5FOM University of Applied Sciences for Economics and Management, Essen,
Deutschland
6Department I of Internal Medicine, Faculty of Medicine and University Hospital
Cologne, University of Cologne, Cologne, Deutschland
Background: Molecular diagnostics of tissue or liquid biopsies are guide-
line-based prerequisites for the provision of targeted (personalized) ther-
apies in non-small cell lung cancer. However, current register studies show
limited test rates in Germany. Outside of the existing trans-sector Specic
Care Contract (SCC) §140a SGB V, molecular diagnostics is reimbursed
in the outpatient but not in the inpatient setting. e aim was hence to
determine the general oer and reimbursement structures of molecular
diagnostics in Germany.
Methods: Based on the assumptions of the principal-agent theory, a path-
way of reimbursement for molecular diagnostics was illustrated from a
hospital perspective. All hospitals treating patients with the ICD-10-GM
diagnosis C34.- ‘lung cancer’ were surveyed using the German Hospital
Directory. Applicable outpatient reimbursement was assigned to each
hospital, subdivided by number of hospital beds and patients treated.
Result: In 2020, lung cancer patients were treated in 1,001 hospital loca-
tions (889 hospitals). 52% of the hospitals (n=462) had no reimbursement
for outpatient services. 89% of these hospitals (n=413) had ≤ 500 beds.
Of 171,824 hospitalized cases, 32% (n=55,826) were treated in hospitals
without reimbursement for outpatient services. Of these cases, 81% were
in hospitals with ≤ 500 beds (n=45,260).
Discussion: e analysis shows numerous hospitals that face economic
burdens without inpatient reimbursement of molecular diagnostics. SCC
§140a SGB V demonstrates a model for trans-sectoral reimbursement
combined with control for quality-assured testing, clinical information,
and thus cancer care. Current hospital reform may change reimbursement
structures in Germany. Concomitant centralization of oncology treat-
ments could enable more patients to access personalized therapies.
Conclusion: Given the clinical benets of molecular testing and per-
sonalized treatment, quality-adjusted reimbursement structures should
be secured in all treatment settings. e national Network Genomic
Medicine is a model example of this.
Disclosure Statement: e authors declare the following: A.-C. Siefen,
J.Trümmler and F. Kron are employees of VITIS GmbH, which was funded by
Noscendo GmbH in connection with the development of this abstract. e funder
of the study had no role in study design, data collection/analysis/interpretation, or
writing of the abstract.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 137
521
Analysis and annotation of next generation sequencing data
with the database Cancer Genome Interpreter
Christoph Jonas1; Jana Fassunke1; Michaela A. Ihle1; Nadina Ortiz-Brüchle2;
Angela Maurer2; Martin Kirschner3; Sabine Merkelbach-Bruse1
1University of Cologne, Faculty of Medicine and University Hospital Cologne,
Köln, Deutschland
2University Hospital of Aachen, Faculty of Medicine, Institute of Pathology,
Aachen, Deutschland
3Department of Hematology, Oncology, Hemostaseology and Stem cell
transplantation, University Hospital RWTH Aachen, Aachen, Deutschland
Background: Cancer Genome Interpreter-Clinics (CGI-Clinics) is a
community-driven database project that aims to improve personalized
medicine in oncology by optimizing genomic data interpretation using
a systematic approach. CGI-Clinics is a European research initiative ini-
tiated by Dr. Nuria Lopez-Bigas and her team (Institute for Research in
Biomedicine, Barcelona) focusing on annotation and interpretation of
variants of unknown signicance and patient empowerment.
Methods: e rst phase of the study is divided into two objectives: 1)
adapting the CGI tool to make it more applicable and accessible for clini-
cal practice and 2) optimizing the machine learning-based algorithms to
interpret the relevance of cancer mutations. For both objectives, somatic
tumor mutations from patients identied by next generation sequencing
(NGS) are used.
Result: CGI-Clinics identies the likely driver alterations in cancer
genes in the tumor type using computational methods (BoostDM and
OncodriveMut). Biomarkers of response to anti-cancer drugs are identi-
ed according to several databases.e special feature of the project is the
increased focus on patients making data and results more accessible. CGI-
Clinics will develop a virtual molecular tumor board and build “eduCGI”,
an app for patients.
Discussion: Data maintenance will remain a challenge as science evolves
and new biomarkers are identied. In this regard further challenges of
CGI clinics are the harmonization of sequencing- and metadata to make
it interoperable for cancer genomics research.
Conclusion: CGI Clinics platform will be a huge benet for cancer
management and personalized medicine by optimizing genomic data
interpretation. Patients will have the opportunity to gain a better under-
standing of their disease and be encouraged to make their data available
for research purposes. is project received funding from the EU Horizon
program HORIZON-HLTH-2021-CARE-05-02 under grant agreement
No. 101057509.
Disclosure Statement: e authors declare no conict of interest.
584
Impact of reference materials on analytical performance
evaluation of liquid biopsy NGS assays and its direct
implications for clinical diagnosis
Thomas Keßler1,2; Ariane Hallermayr1,2,3; Moritz Fujera1; Ben Liesfeld4;
Samuel Bernstein4; Simon von Ameln5; Denny Schanze6; Verena Steinke-
Lange1,2,3; Julia MA Pickl1,3; Teresa Neuhann1; Elke Holinski-Feder1,2,3
1MGZ – Medizinisch Genetisches Zentrum, München, Deutschland
2European Liquid Biopsy Society, Hamburg, Deutschland
3Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der
Universität München, München, Deutschland
4Limbus Medical Technologies GmbH, Rostock, Deutschland
5Immune-Oncological Centre Cologne (IOZK), Köln, Deutschland
6Institute of Human Genetics, University Hospital Magdeburg, Otto-von-
Guericke University, Magdeburg, Deutschland
Background: Liquid biopsy (LB) enables non-invasive analysis of genetic
tumor variants in circulating free DNA (cfDNA) in plasma to support per-
sonalized treatment. Most cancer patients present with actionable tumor
variants in plasma with variant allele frequencies (VAFs) <1%. us,
accurate analytical validation of LB assays at the lower end of the meas-
urement scale is mandatory to maximize clinical assay utility, particularly
regarding the In Vitro Diagnostic Regulation (IVDR). Selection of appro-
priate reference materials is the rst and key prerequisite for this purpose.
Methods: Six types of commercial cfDNA reference materials and 42 patient
samples were analyzed using a duplex sequencing-based LB NGS assay.
Firstly, we evaluated the similarity of the reference materials to native cfDNA.
Secondly, we determined the materials background noise, a step critical for
accurate assessment of precision and sensitivity of the analytical assays.
Result: We observed signicant dierences between reference materials
in terms of wet-lab and sequencing quality as well as in background noise.
No reference material resembled native cfDNA in all performance metrics
investigated. Based on our results, we established guidelines for the selec-
tion of appropriate reference materials for improved LB assay validation.
Discussion: Careful consideration of reference materials is required for
dierent steps of LB assay validation. Similarity to native cfDNA aids the
development of experimental protocols, while reference materials with
well-dened variants and low background noise are preferable for determin-
ing assay precision and sensitivity. As none of the tested reference material
proved optimal for all validation steps, our proposed guidelines support the
implementation of appropriately validated LB assays in clinical diagnostics.
Conclusion: e use of appropriate reference materials and detection cut-
os is required to ensure optimal sensitivity for variant detection in LB
assays facilitating accurate clinical interpretation across laboratories.
Disclosure Statement: e authors declare no conict of interest.
598
Multi-omics analysis to uncover the molecular basis of tumor
budding in head and neck cancer
Iordanis Ourailidis1,2; Fabian Stögbauer3; Katja Steiger3; Susanne Beck1;
Wilko Weichert3; Peter Schirmacher1; Albrecht Stenzinger1;
Melanie Boxberg3; Jan Budczies1
1Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg,
Deutschland
2Faculty of Biosciences, Heidelberg University, Heidelberg, Deutschland
3Institut für Pathologie, Technische Universität München, München,
Deutschland
Background: Tumor budding (TB) evaluated by the analysis of histo-
pathological slides is associated with lymph node metastasis and unfa-
vorable prognosis in HPV+ and HPV- head and neck squamous cell
carcinoma (HNSCC) [1]. e molecular mechanisms underlying TB are
incompletely understood.
Methods: We analyzed digital histopathological slides, mutation data,
transcriptomics data, and survival data of HNSCC from TCGA (n=325).
Gene lists were compiled to include genes showing signicant (FDR=5%)
Spearman correlations of at least R=0.25 of mRNA expression with TB.
Gene set enrichment with respect to 50 hallmarks gene sets was carried
out separately for the lists of positively and negatively correlating genes.
Protein expression of CAV1 and MMP14 was analyzed using immunohis-
tochemistry in an independent cohort (n=41).
Result: TB was associated positively with TP53 mutations in HPV+
tumors and negatively with NSD1 mutations in HPV- tumors. In HPV+
HNSCC, 786 genes correlated signicantly with TB, while in HPV-
HNSCC 422 genes correlated signicantly with TB. e positively corre-
lating genes in HPV+ HNSCC were enriched for epithelial-mesenchymal
transition (EMT), while the negatively correlating genes were enriched for
two categories related to proliferation. e positively correlating genes in
HPV- HNSCC were enriched for EMT, coagulation, hypoxia, and further
categories, while there was no enrichment for the negatively correlating
genes. e correlation of CAV1 and MMP14 with TB observed in the
TCGA could be validated in the independent cohort. e proteins were
expressed as follows: low in tumors w/o TB, intermediate in the bulk of
tumors with TB, and high in tumor buds.
Discussion: We conrmed an association of TB and epithelial-mesenchy-
mal transition that was reported in earlier studies.
Conclusion: Molecular correlates of TB were uncovered in a system-
atic analysis combining histopathology and -omics data. e detected
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts138
markers, in particular CAV1 and MMP14, warrant further evaluation as
biomarkers.
Reference:
[1] Stögbauer F et al., Br J Cancer. 2023, 128(12):2295.
Disclosure Statement: e authors declare the following: JB and MB: funding by
the German Cancer Aid (grants 70113973 and 70113976). JB: consulting fees by
MSD. MB: consulting fees by BMS. AS: grants by Bayer, BMS, Chugai, and Incyte.
AS: Advisory Boards/Speaker’s Bureau: Agilent, Aignostics, Amgen, Astra Zeneca,
Bayer, BMS, Eli Lilly, Illumina, Incyte, Janssen, MSD, Novartis, Pzer, Qlucore,
Roche, Seagen, Takeda, ermo Fisher. PS: funding by Roche, Chugai, BMS,
Novartis. PS: Advisory Board/Speaker’s Bureau: Astra Zeneca, Incyte, Janssen.
736
Implementation of a customized Easy®PGX qPCR assay for
fast-track analysis of lung cancer samples
Svenja Wagener-Ryczek; Roberto Pappesch; Jana Fassunke;
Christoph Jonas; Michaela A. Ihle; Carina Heydt; Janna Siemanowski;
Vanessa Welter; Sabine Merkelbach-Bruse; Udo Siebolts
Uniklinik Köln Institut für Pathologie, Köln, Deutschland
Background: e detection of somatic gene variants, splicing variants and
targetable fusions plays and important role in cancer precision medicine.
With improvement of multiplex DNA and RNA-based sequencing meth-
ods, the spectrum of molecular targets tested increased. e major draw-
back is the increasing turnaround time until delivery of results. To face
the demand for comprehensive best standard molecular diagnostics with
a fast therapy decision, the implementation of a fast-track analysis upfront
NGS-based analyses oers a solution
Methods: For the detection of variants and fusions, a customized qPCR
assay system was applied on an Easy®PGXplatform. In brief, 10ng DNA
and 15ng RNA extracted separately from formalin-xed paran-embed-
ded (FFPE) tissue samples were taken as input for each reaction well of
the customized Easy®PGX fast-track assay (Diatech Pharmacogenetics
S.R.L). Data analysis was performed with the Easy®PGX soware for
DNA and RNA.
Result: Using the above described fast-track system, 750 DNA and 750 RNA
samples were analysed. Variants in EGFR exon 19, insertions in EGFR exon
20, BRAF Codon V600 and KRAS codon 12 variants were analysed on DNA
level, whilst well-evaluated and targetable fusions in ALK, RET and ROS
as well as MET exon 14 skipping were analysed on RNA level. Individual
thresholds of ct values were evaluated and detection limits were identied.
Discussion: is study aimed to evaluate the technical feasibility of ana-
lyzing therapeutically relevant molecular targets in lung cancer samples.
Particularly, the study tested the robustness and detection limits of each
variant- and fusion assays included. Individual thresholds of ct values for
each assay and the eective application of downstream validation assays
completes the need for fast delivery of molecular results with high preci-
sion and sensitivity of molecular testing.
Conclusion: is method demonstrated robust detection of rst-line ther-
apeutically relevant target aberrations leading to faster therapy decision
and complements molecular diagnostics via larger NGS-based methods.
Disclosure Statement: e authors declare no conict of interest.
757
The Genomic Evolution of Recurrence Development in
Chordoma - A Whole Exome Study Comparing Primary Tumors
and Long-Term Recurrences
Sarah Rebecca Ullmann; Albert Roessner; Julian Schreier;
Sabine Franke; Dörthe Jechorek; Franziska Karras
Universitätsklinikum Magdeburg, Institut für Pathologie, Magdeburg,
Deutschland
Chordomas are rare malignant bone tumors, with a high recurrence rate.
ere is no data on the genomic landscape of long-term recurrences.
erefore, we performed a whole exome sequencing study (WES), to
detect alterations that aren’t included in targeted panels. We investigated
four patients with multiple recurrences over seven to 16 years and eight
patients with primary, sacral chordomas in order to compare both groups
as well as the recurrence cases to each other. Our aim was to nd genomic
dierences between primary and recurrent tumors and identify driver
mutations of long-term recurrences. Aer histopathological classication
and immunohistochemical staining, DNA and miRNA was extracted from
formalin-xed-paran-embedded (FFPE) tissue samples. e DNA was
analysed by WES using a NextSeq high-throughput sequencing instrument,
the miRNA via Nanostring. MiRNA regulation patterns showed similari-
ties within cases with long- term recurrences. Our WES analysis conrmed
previously described driver genes and revealed possible new driver genes
next to broad alterations in pathways eecting embryonic and notochordal
development. Histologically all cases were of conventional type. While no
dierences could be observed on histological grounds, genomic distinctions
were obvious. Primary cases displayed a dierent distribution of genomic
mutations, showing remarkably fewer disturbances in embryonic signaling
and our proposed driver genes. Intriguingly, our study found a progress in
number of alterations throughout the recurrences most of all eecting chro-
matin regulatory but also in FAT, GRM and the HOX family. Less disrup-
tion of these pathways in primary cases than in recurrences implies their
pivotal role not only in chordoma formation, but also in recurrence evolu-
tion. Combined genomic and clinical studies, concentrating on embryonic
signaling, chromatin regulation, and our proposed new driver genes, could
expand understanding of recurrence development and possibly lead to new
therapeutic targets inhibiting or delaying recurrence formation.
Disclosure Statement: e authors declare no conict of interest.
774
Determining MSI status of prostate and cholangiocellular
carcinoma by genome wide NGS
Janna Siemanowski; Peony Poon; Udo Siebolts;
Sabine Merkelbach-Bruse
Uniklinik Köln Institut für Pathologie, Köln, Deutschland
Background: In order to nd new therapeutic targets, genomewide-next
generation sequencing (NGS) approaches for the analysis of multiple
biomarkers are used. Microsatellite instability (MSI) is one of them. As
validated cut-os are not available for a wide range of entities we aimed
to establish suitable thresholds for prostate (PCa) and cholangiocellular
carcinoma (CCC).
Methods: For mismatch repair (MMR) immunohistochemistry (IHC)
tumor sections were stained for MLH1 (Clone: M1, Ventana), MSH2
(G219-1129), MSH6 (EPR3947) and PMS2 (Clone: 44, Ventana) on a
Ventana Benchmark stainer. For MSI analysis, the TruSight Oncology 500
Kit was used (Illumina). Sequencing was performed using the Nextseq
or Novaseq (Illumina). MSI analysis of 130 noncoding homopolymer
regions was done with the TSO500 Local App (Illumina), analysis of addi-
tional di-, tri- and tetranucleotid repeats was done with MSIsensor-pro1.
Result: 44 CCC and 59 PCa samples were analysed. Using published
thresholds (20-30% of unstable MSI loci)2,3, one CCC and no PCa were
identied as MSI-High (MSI-H). Another CCC case and two PCa cases
harbouring mutations in MLH1, MSH2 or MSH6 were identied as
MSI-H aer MMR IHC testing. In these samples, percentage of unstable
loci ranged from 3.23% (CCC) to 7.26-13.76% (PCa).
Discussion: Since MSI proles can dier between cancer entities, thresh-
olds for instability must be determined for each of them individually4.
Especially when using mononucleotide markers small shis might be
missed. Here we showed that already published cut-os calculated for
other entities cannot be easily transferred to PCa and CCC.
Conclusion: MSI estimation using NGS is suitable as a quick screening
tool. Since thresholds for MSI-H might dier enormously between enti-
ties, additional IHC testing is recommended at least in samples where
VUS or pathogenic mutations are found in one of the mismatch repair
genes.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 139
Indication of source:
1 Peng et al., GPB 2020.
2 Zhao et al., bioRxiv 2020.
3 Kroeze et al., J Mol Diagn. 2020.
4 Siemanowski et al., Cancers 2021.
Disclosure Statement: e authors declare no conict of interest.
778
Utility of miRNA miR-371a-3p for the early detection of
metastases in testicular germ cell tumors
Roberto Pappesch; Felix Seelemeyer; Sabine Merkelbach-Bruse;
Axel Heidenreich; Udo Siebolts
Uniklinik Köln, Köln, Deutschland
Purpose: Eective management of testicular germ cell tumors (GCTs)
involves monitoring of serum tumor markers like AFP, beta HCG, and
LDH. However, 50-60% of GCTs do lack these markers, causing challenges
for clinical decisions. MicroRNAs (miRNAs), particularly miR-371a-3p,
have emerged as promising GCT biomarkers due to their high sensitivity
and specicity (≥90%) compared to conventional biomarkers. Initial data
suggest superiority of this marker in monitoring potential progression.
To explore the potential for early metastasis detection in seminomas and
nonseminomas, miRNA levels were tracked from December 2021 to pres-
ent, correlating measurements with metastasis occurrence for 16 patients.
Methods: Sixteen patients with marker-negative clinical stage (CS)
IIA/B seminomas (n=10) and nonseminomas (n=6) underwent primary
nerve-sparing retroperitoneal lymph node dissection (nsRPLND). Blood
samples collected pre-surgery were processed following standart oper-
ation protocols. miRNA was extracted and puried using the Maxwell
RSC MiRNA Plasma and Serum Kits (Promega). Following manufactur-
ers protocol (mirdetect) miR-371a-3p and the endogenous control miR-
30b-5p were reverse transcribed to cDNA. Quantitative polymerase chain
reaction was performed on the Roche Lightcycler 480 II. Results were
documented as relative quantity (RQ) values.
Results: Histology showed metastatic seminoma/nonseminoma in 12/16
(75%) cases. Non-malignant conditions, teratoma, and lymphoma were
found in 4 patients. miR-371 positivity was 100% (12/12) in metastatic
patients and 75% (3/4) in non-metastatic cases. One patient with small
volume CS IIA seminoma showed false negative results.
Discussion: is study underscores miR-371’s utility as a personalized
biomarker predicting small volume retroperitoneal lymph node metasta-
ses in CS IIA/B seminomas and nonseminomas.
Conclusion: Positive ndings suggest that miR-371 expression is a good
predictive biomarker and should result in active treatment, while negative
results warrant vigilant follow-up.
Disclosure Statement: e authors declare no conict of interest.
844
The Role of BMP/TGF-β Signaling in the Development of
Dedierentiated Chondrosarcoma
Franziska Karras; Julian Schreier; Sarah Rebecca Ullmann;
Sabine Franke; Albert Roessner; Dörthe Jechorek
Universitätsklinik Magdeburg - Institut für Pathologie, Magdeburg, Deutschland
Background: Dedierentiated chondrosarcoma (DDCS) is a rare and
aggressive cartilage tumor originating out of a low-grade chondrosarcoma.
e typical histological characteristic is a coexistence of a well-dierenti-
ated and a dedierentiated component. Despite the obvious histological
dierences, the underlying mechanisms of DDCS development are widely
unknown. In a preliminary study, we identied dierential expressed miR-
NAs in the dedierentiated components in comparison to the well-dif-
ferentiated components of paired DDCS samples [1]. Validated targets of
these miRNAs are components of BMP/TGF-β signaling. erefore, we
performed a genomic and epigenetic analysis of 10 DDCS cases with focus
on BMP/TGF-β signaling.
Methods: We extracted DNA and miRNA from FFPE tissue samples of
DDCS. e DNA was analyzed by WES and miRNA expression by the
miRNA Expression Panel for the NanoString nCounter MAX analysis sys-
tem. Immunohistochemical expression of BMPR2, TGFBR2 and SMADs
was evaluated in detail in the well-dierentiated and dedierentiated
tumor components.
Result: We could identify several pathogenic mutations, as well as signi-
cantly deregulated miRNAs, inuencing components of the BMP/TGF- β
signaling, e.g. BMPR2, TGFBR2 and SMADs.
Discussion: So far, the underlying mechanisms of the development of
DDCS is widely unknown. Our results indicate an involvement of the
BMP/TGF-β signaling in the dedierentiation.
Conclusion: In this study, we combined the analyses of the mutation pro-
le and the dierential miRNA expression in the dierent DDCS compo-
nents. e revealed dierences between the both components could be a
new hint for the underlying mechanisms of the dedierentiation process
of conventional chondrosarcoma.
Reference:
1 FS Karras et al., Comparative Analysis of miRNA Expression in Dedierentiated
and Well-Dierentiated Components of Dedierentiated Chondrosarcoma,
Pathol Res Pract (2023) 154414. https://doi.org/10.1016/j.prp.2023.154414.
Disclosure Statement: e authors declare no conict of interest.
888
Implementation of a Molecular Tumor Board (MTB) – One-year
Experience
Lena Häberle1; Simon Labuhn2; Martin Schlensog1; Wolfgang Göring1;
Karl-Ludwig Schäfer1; Kai Horny3; Silke Redler4; Tilman Rau1;
Wolfram T Knoefel5; Arndt Borkhardt6; Irene Esposito1
1Heinrich Heine University & University Hospital Duesseldorf, Institute of
Pathology, Duesseldorf, Deutschland
2Heinrich Heine University & University Hospital Duesseldorf, Department
of Gastroenterology, Hepatology and Infectious Diseases, Duesseldorf,
Deutschland
3Heinrich Heine University & University Hospital Duesseldorf, Institute of
Medical Biometry and Bioinformatics, Duesseldorf, Deutschland
4Heinrich Heine University & University Hospital Duesseldorf, Institute of
Human Genetics, Duesseldorf, Deutschland
5Heinrich Heine University & University Hospital Duesseldorf, Department of
General, Visceral and Thoracic Surgery, Duesseldorf, Deutschland
6Heinrich Heine University & University Hospital Duesseldorf, Department of
Paediatric Oncology, Haematology and Immunology, Duesseldorf, Deutschland
Background: Molecular tumor boards (MTBs) have become a pivotal
platform to translate results from molecular analyses into patient care.
e goal of the MTB panel consisting of oncologists, pathologists, human
geneticists, bioinformaticians and other experts is to facilitate an indi-
vidualized therapy recommendation for each patient based on molecular
data and considering the clinical situation.
Methods: Aer implementation of a local MTB at the University Hospital
of Duesseldorf (UKD) in July 2022, MTB data were collected systemati-
cally and evaluated aer one year.
Result: Patient numbers increased almost 4-fold comparing the rst
6 months with the last 6 months of operation. Human genetic analysis
results were available in 8% of cases. In 11%, human genetic counseling
and diagnostics were recommended. erapy recommendations were
made in almost 2/3 of MTB cases. Recommendations were based on
small variants in 42%, fusions in 5%, and other markers (e.g., microsat-
ellite instability, Her2/neu positivity) in 53%. erapy studies were rec-
ommended in 24%, while o-label therapies were recommended in 30%.
EMA-approved targeted therapies were available in 10%. MTB recom-
mendations were implemented in 34% of cases. Non-adherence to MTB
recommendations was mainly due to (a) still available and eective stand-
ard therapy options (38%), and (b) death or deterioration of the patients
general condition within 4 weeks of the MTB (30%).
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts140
Discussion: MTBs are useful to pool interdisciplinary resources and create
individual therapy recommendations. While recommendations are feasi-
ble for the majority of MTB cases, the actual realization of therapy options
may be challenging. e optimal time point for the MTB presentation
seems to be crucial for the implementation of therapy recommendations.
Conclusion: Systematic data collection and analysis from MTBs are
needed to improve MTB eectiveness. Importantly, follow-up informa-
tion on therapy response will be inquired to assess patients’ benet from
MTB inclusion.
Disclosure Statement: e authors declare no conict of interest.
926
Targeting metabolic pathways important for human cancer
cells with an ultramutator phenotype
Gleice Borges1,2; Isabell Vetterlein2; Mona Reichel1,2; Mara Sannai2;
Philipp Koch2; Torsten Kroll2; Ilkka Miinalainen3; Berit Jungnickel1;
Helmut Pospiech2,4
1Friedrich-Schiller-Universität Jena, Jena, Deutschland
2Leibniz-Institut für Alternsforschung - Fritz-Lipmann-Institut Jena, Jena,
Deutschland
3University of Oulu, Oulu, Finnland
4Forschungslabore der Klinik für Frauenheilkunde und Geburtshilfe,
Universitätsklinikum Düsseldorf, Life Science Center, Düsseldorf, Deutschland
Background: Pathogenic variants POLE that encodes for the catalytic
subunit of DNA polymerase (Pol) ε have been associated with ultramu-
tated cancers. Genetic alterations underlying this phenotype target the
proofreading exonuclease of Pol ε. We study the eects of Pol ε exonu-
clease defects on the function of a model cancer cell line. ereby, we aim
to identify and characterize genes involved in metabolic pathways, whose
loss is detrimental for the survival of ultramutated cancer cells.
Methods: We performed a genome-wide knock-out screen of a nearly
haploid human HAP1 cancer cell model decient in Pol ε proofread-
ing followed by validation using siRNA knock-downs in order to iden-
tify potential synthetic lethal genes and underlying pathways relevant
for ultramutated cells. Selected targets were characterized by Western
blots, metabolic analysis and clonogenic survival aer pharmacological
intervention.
Results: We identied genes whose inactivation reduces proliferation and
viability in Pol ε proofreading-decient, but not in parental cells wild type
(WT) for Pol ε. Enrichment analysis of the identied hits suggests that loss
of genes involved in transcription, RNA/protein metabolism and trans-
port, mitochondrial translation, cell adhesion/cytoskeleton would reduce
the survival of ultramutated cells compared to WT cells.
Conclusion: Our analysis identied energy and protein homeostasis as
processes particularly important for ultramutated cells that provide new
potential targets for the treatment of ultramutated cancers.
Disclosure Statement: e authors declare no conict of interest.
Novel Therapeutics: Clinical Trials
445
Bewertung des Nutzens von NEPA (xe Kombination von
Netupitant/Palonosetron) zur Vorbeugung von durch
Chemotherapie ausgelöster Übelkeit und Erbrechen (CINV)
bei Patienten mit erhöhtem Emesisrisiko, die eine moderat
emetogene Chemotherapie erhalten
Meinolf Karthaus1,2; Daniel Christoph3; Michael Patrick Lux4;
Ralf-Dieter Hofheinz5; Karin Jordan6
1Klinikum Neuperlach, München, Deutschland
2München Klinik Neuperlach, München, Deutschland
3Evang Klinikum Essen, Essen, Deutschland
4Klinik für Gynäkologie und Geburtshilfe, Frauenklinik St. Louise, Paderborn,
Deutschland
5Mannheim Cancer Center, Mannheim, Deutschland
6Department for Haematology, Oncology and Palliative Care, Potsdam,
Deutschland
Background: In patients receiving moderately emetogenic chemotherapy
(MEC), antiemetic guidelines lack evidence to recommend an NK1 recep-
tor antagonist (RA) for all patients; therefore, they endorse a 5-HT3 RA
+ dexamethasone (DEX). However, the NCCN guidelines recognize that
this approach oen results in inadequate prophylaxis and include an NK1
RA-containing option for patients with individual emetic risk factors (e.g.,
prior CINV, age <50, female). Evidence present that NEPA (a xed com-
bination of an NK1 RA, (fos)netupitant, and a 5-HT3 RA, palonosetron) is
eective in a pragmatic multi-center study (Zelek 2021) in a heterogene-
ous population of patients with cancer receiving anthracycline/cyclophos-
phamide (AC) or MEC and in patients with CINV risk factors.
Trial Design: is is a Phase IV, randomized, open-label, multicenter,
multinational study conducted in 7 countries (NCT04817189). An algo-
rithm incorporating 7 predictive risk factors (adapted from Dranitsaris
2017) is used to select patients at increased risk of CINV. Suitable patients
≥18 years, naïve or non-naive to chemotherapy, with a diagnosis of any
cancer scheduled to receive 3 consecutive cycles of an intravenous MEC
regimen, are randomized to either NEPA + DEX or the 5-HT3 RA + DEX
standard of care. A single dose of oral NEPA + 8 mg DEX or a 5-HT3 RA
+ DEX is administered on day 1.
e Multinational Association of Supportive Care in Cancer (MASCC)
Antiemesis Tool (MAT) is used to capture nausea and vomiting
post-chemotherapy. e primary endpoint is complete response (CR: no
emesis, no rescue use) during the overall (0-120 h) phase post-chemother-
apy over 3 cycles. A generalized linear model will analyze CR over 3 cycles
of MEC with logit link function, binomial distribution, and with study
treatment, carboplatin use, and the country as factors.
A total of 530 patients are planned (265/group) worldwide. Enrolment
is open; as of August 10, 2023, 349 patients have been randomized. In
Germany, the recruitment is closed with 96 patients that have been
enrolled by ve study centers.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 141
811
TIGER PRO-Active: patient-reported neurocognitive
functioning and app-based assessment of daily activity and
sleep in glioblastoma patients treated with TTFields therapy
Martin Glas1,2; Ghazaleh Tabatabai3; Rainer Fietkau4;
Roland Goldbrunner5; Oliver Bähr6
1Universitätsklinikum Essen, Klinik für Neurologie, Abteilung für Klinische
Neuroonkologie, Essen, Deutschland
2Universitätsklinikum Essen, West German Cancer Center (WTZ) and German
Cancer Consortium Partner Site, Essen, Deutschland
3Universitätsklinikum Tübingen, Department of Neurology and Interdisciplinary
Neurooncology, Tübingen, Deutschland
4Universitätsklinikum Erlangen, Department of Radiation Oncology, Erlangen,
Deutschland
5Universitätsklinikum Köln, Zentrum für Neurochirurgie, Köln, Deutschland
6Hospital Aschaenburg-Alzenau, Clinic of Neurology, Aschaenburg,
Deutschland
Background: TTFields therapy is approved for newly diagnosed glioblas-
toma (ndGBM), recommended by the DGN and DGHO guidelines, and a
service of the statutory health insurance funds. Additional real-world data
is warranted. TIGER study (NCT03258021) provides insight into patients
therapy decisions, TTFields therapy duration and usage, health-related
quality-of-life (HRQoL), survival, and adverse events (AEs) in the real-
world clinical setting. We established the TIGER PROgram (collaborative
network of centers involved in the TIGER study including new centers in
Germany) to collect additional real-world evidence. TIGER PRO-Active
study (NCT04717739; rst study initiated within program) will inves-
tigate daily activity, sleep, and neurocognitive functioning in ndGBM
patients who were treated with TTFields therapy in routine clinical care
in Germany.
Study design e prospective, non-interventional, multicenter TIGER
PRO-Active study in Germany is the rst to assess disease course by
means of digitally-measured parameters. Approximately 500 adult
ndGBM patients will be recruited in accordance with the treatment
indication for TTFields therapy over a span of 2-years. Patient-reported
change from baseline scores in daily physical activity and sleep (using
smartphone-based apps) and neurocognitive functioning (using validated
Montreal Cognitive Assessment [MoCA] interview test) will be assessed.
HRQoL will be evaluated (using validated, patient-reported EORTC
QLQ-C30 and BN20 questionnaires). Employment status, therapy usage,
and serious AEs will be assessed. Data will be collected for ≥12 months.
Conclusion: TIGER PROgram will allow use of previously-established
administrative structures to conduct new real-world studies, enabling
use of a basic dataset across dierent trials and to facilitate meta-analy-
ses across dierent populations. TIGER PRO-Active study will provide
detailed insights into app-captured daily physical activity and sleep, and
neurocognitive functioning of ndGBM patients using TTFields therapy in
routine clinical care.
Disclosure Statement: e authors declare the following: Authors are
collaborators of Novocure
Novel Therapeutics: Targeted Therapies,
Immunotherapies, Cellular Therapies
43
Idecabtagene vicleucel (ide-cel) versus standard (std)
regimens in triple-class–exposed (TCE) relapsed and
refractory multiple myeloma (RRMM): KarMMa-3 subgroup
analysis in patients (pts) receiving bridging therapy
Hermann Einsele1; Paula Rodríguez-Otero2; Bertrand Arnulf3; Krina Patel4;
Salomon Manier5; Luciano J. Costa6; Nizar J Bahlis7; Annemiek Broijl8;
Christine Chen9; Ingerid Weum Abrahamsen10; Michel Delforge11;
Usama Gergis12; Marc S Raab13; Seema Singhal14; Rafat Abonour15;
Anna Truppel-Hartmann16; Rashmi Bhatnagar17; Jasper Felten18;
Andrea Caia18; Fan Wu18; Julia Piasecki18; Mark Cook19;
Sikander Ailawadhi20
1Universitätsklinikum Würzburg (UKW), Würzburg, Deutschland
2Clínica Universidad de Navarra, Pamplona, Spanien
3Hôpital Saint-Louis, APHP, Université Paris Cité, Paris, Frankreich
4MD Anderson Cancer Center, The University of Texas, Houston, USA
5Centre Hospitalier Universitaire de Lille, Université de Lille, Lille, Frankreich
6University of Alabama at Birmingham, Birmingham, USA
7Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Canada
8Erasmus MC Cancer Institute, Rotterdam, Niederlande
9Princess Margaret Hospital, Toronto, Canada
10Oslo University Hospital, Oslo, Norwegen
11Universitaire Ziekenhuizen Leuven, Leuven, Belgien
12Thomas Jeerson University, Philadelphia, USA
13Universitätsklinikum Heidelberg, Heidelberg, Deutschland
14Robert H. Lurie Comprehensive Cancer Center of Northwestern University,
Chicago, USA
15Indiana University School of Medicine, Indianapolis, USA
162seventy bio, Cambridge, USA
17Syneos Health, Haryana, Indien
18Bristol Myers Squibb, Princeton, USA
19Celgene International Sarl, a Bristol-Myers Squibb Company, Boudry, Schweiz
20Mayo Clinic, Jacksonville, USA
Background: Ide-cel, a BCMA-directed CAR T cell treatment (Tx),
improved median progression-free survival (mPFS) and overall response
rates (ORR) vs std regimens in pts with TCE RRMM (KarMMa-3;
NCT03651128).
Methods: Ide-cel-randomized pts in KarMMa-3 could receive ≤ 1 cycle of
bridging Tx (BTx). Disease burden (DB) was based on measurable disease
pre-leukapheresis (LK; serum/urine M-protein, M-protein, or dierence
between involved/uninvolved free light chain). Pts were grouped based on
DB change from LK to ide-cel (≥ 25% increase [I]; ≥ 25% decrease [D];
no change [NC]). Ecacy (PFS, ORR, CRR, duration of response [DOR])
and safety were assessed.
Result: 213/254 ide-cel-randomized pts received BTx; 200 were evaluable
for change in DB pre-ide-cel (DPd, n = 45; DVd, n = 20; IRd, n = 25; Kd,
n = 26; EPd, n = 59; other, n = 25) (I, n = 59 [28%]; D, n = 32 [15%]; NC,
n = 109 [51%]). Median number of cycles for all BTx regimens was 1.
More pts with increased disease had baseline high-risk MM characteris-
tics (extramedullary plasmacytoma, I, 41%; D, 16%; NC, 24%; high-risk
cytogenetics, I, 53%; D, 25%; NC, 38%; triple-class–refractory disease, I,
90%; D, 63%; NC, 59%). mPFS (95% CI) was numerically longer in D vs
I/NC pts (I, 6.9 [2.4–11.8]; D, 20.7 [11.2–NR]; NC, 15.1 [12.4–17.3] mo).
ORR (95% CI) was numerically higher in D vs I/NC pts (I, 56% [43–69];
D, 97% [91–100]; NC, 80% [72–87]), with deeper (CRR: I, 32%; D, 56%;
NC, 39%), more durable (mDOR [95% CI]: I, 9.3 [7.5–17.3]; D, 18.6 [8.6–
NR]; NC, 13.4 [10.9–21.4] mo) responses. Any-grade (G; I, 90%; D, 97%;
NC, 96%) and G3/4 adverse event (AE; I, 81%; D, 84%; NC, 95%) inci-
dence was similar. G5/serious AEs occurred in 15%/42% (I), 6%/25% (D)
and 13%/44% (NC); any-G cytokine release syndrome in 80% (I), 94%
(D), and 84% (NC); G3/4 in 7%, 3%, and 4%; any-G investigator-identi-
ed neurotoxicity in 24% (I), 3% (D), and 13% (NC); G3/4 in 3%, 0%, and
4%, respectively.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts142
Discussion: Ide-cel lead to longer mPFS and greater response in pts with
TCE RRMM who had D/NC vs I in DB with BTx.
Conclusion: Ide-cel prolongs mPFS with consistent safety.
First presented: IMS 2023 Annual Congress.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
237
Idecabtagene vicleucel (ide-cel) versus standard regimens in
patients (pts) with triple-class–exposed (TCE) relapsed and
refractory multiple myeloma (RRMM): a KarMMa-3 analysis in
the modied intent-to-treat (mITT) population
Christoph Scheid1; Salomon Manier2; Sikander Ailawadhi3;
Paula Rodríguez-Otero4; Bertrand Arnulf5; Krina Patel6; Scott R. Solomon7;
Rachid Baz8; Sundar Jagannath9; Noopur Raje10; Maria-Victoria Mateos11;
Al-Ola Abdallah12; Hermann Einsele13; Sergio Giralt14; Thomas Pabst15;
Aurore Perrot16; Yi Lin17; Anna Truppel-Hartmann18; Rashmi Bhatnagar19;
Jasper Felten20; Andrea Caia20; Julia Piasecki20; Mark Cook21;
Philippe Moreau22
1University Hospital of Cologne, Cologne, Deutschland
2Centre Hospitalier Universitaire de Lille, Université de Lille, Lille, Frankreich
3Mayo Clinic Florida, Jacksonville, USA
4Clínica Universidad de Navarra, Pamplona, Spanien
5Hôpital Saint-Louis, Assistance Publique–Hôpitaux de Paris, Université Paris
Cité, Paris, Frankreich
6MD Anderson Cancer Center, The University of Texas, Houston, USA
7Northside Hospital Cancer Institute, Atlanta, USA
8H. Lee Mott Cancer Center, Tampa, USA
9Mount Sinai Medical Center, New York, USA
10Massachusetts General Hospital, Boston, USA
11Hospital Clínico Universitario de Salamanca, Salamanca, Spanien
12University of Kansas Cancer Center, Kansas City, USA
13University Hospital Würzburg, Würzburg, Deutschland
14Memorial Sloan Kettering Cancer Center, New York, USA
15University Hospital Inselspital and University of Bern, Bern, Schweiz
16Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, Frankreich
17Mayo Clinic, Rochester, USA
182seventy bio, Cambridge, USA
19Syneos Health, Haryana, Indien
20Bristol Myers Squibb, Princeton, USA
21Celgene International Sarl, a Bristol-Myers Squibb Company, Boudry, Schweiz
22University Hospital Hôtel-Dieu, Nantes, Frankreich
Background: With combination regimens use, including immuno-
modulatory agents, proteasome inhibitors, and daratumumab, pts with
RRMM become TCE earlier in their treatment (Tx). In KarMMa-3
(NCT03651128), ide-cel signicantly improved median progression-free
survival (mPFS) and overall response rates (ORR) versus standard (std)
regimens in pts with TCE RRMM (Rodríguez-Otero P et al, NEJM 2023).
Ecacy was analyzed in the KarMMa-3 ITT population (pop). We report
outcomes in the mITT pop who received the study Tx.
Methods: Pts with RRMM who received 2–4 prior lines of Tx, were TCE,
and had disease refractory to the last regimen, were randomized 2:1 to
receive ide-cel or a std regimen (DPd, DVd, IRd, Kd or EPd). PFS, ORR,
and safety were assessed in the mITT pop.
Result: Of the 386 pts in the ITT pop, 351 received study Tx and con-
stituted the mITT pop (225 pts, ide-cel; 126 pts, std regimens). Baseline
characteristics were balanced between Tx arms, and comparable to the
ITT pop. Tx with ide-cel led to longer PFS vs std regimens (mPFS [95%
CI], 14.5 [12.2−17.3] vs 4.4 [3.4−5.9] mo; HR 0.43; 95% CI, 0.33−0.56).
ORR was higher with ide-cel vs std regimens (80% vs 44%), with higher
rates of deep response (≥ complete response: 44% vs 6%). Grade (G) 3/4
AEs occurred in 213/225 (95%) and 94/126 (75%) pts in the ide-cel and
std regimens arms, respectively; most commonly neutropenia (80% vs
40%), anemia (51% vs 18%), and thrombocytopenia (44% vs 17%). G 5
AEs occurred in 12% and 6% of pts, of which 5% and 2%, respectively,
were due to disease progression.
Discussion: Only 35 randomized pts in the ITT pop did not receive ide-
cel (n = 29) or std regimens (n = 6). A greater proportion of pts who did
not receive ide-cel had high-risk features vs the mITT pop (R-ISS stage III
[38% vs 9%] and higher tumor burden [52% vs 25%]). Compared with the
ITT pop, mPFS for ide-cel was longer in the mITT pop while mPFS for
std regimens remained the same, reecting ide-cel ecacy in infused pts.
Conclusion: In the mITT pop, the benet of ide-cel over std regimens was
consistent with that observed in the ITT pop.
First presented: IMS 2023 Annual Congress.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
262
TRANSCEND FL: phase 2 study results of lisocabtagene
maraleucel (liso-cel) in patients (pts) with relapsed/refractory
(R/R) follicular lymphoma (FL)
Peter Borchmann1,2; Franck Morschhauser3; Saurabh Dahiya4; M. Lia
Palomba5; Alejandro Martín García-Sancho6; Juan Luis Reguera Ortega7;
John Kuruvilla8; Ulrich Jäger9; Guillaume Cartron10; Koji Izutsu11;
Martin Dreyling12; Brad Kahl13; Hervé Ghesquieres14; Kirit Ardeshna15;
Hideki Goto16; Anna Maria Barbui17; Jeremy S. Abramson18;
Isabelle Fleury19; Stephan Mielke20; Thalia Farazi21; Omotayo Fasan22;
James Lymp23; Min Vedal23; Rina Nishii22; Ariel Avilion23; Jessica Papuga24;
Loretta J. Nastoupil25
1Universität zu Köln, Köln, Deutschland
2Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD),
Cologne, Deutschland
3Centre Hospitalier Universitaire de Lille, Lille, Frankreich
4Stanford University School of Medicine, Stanford, USA
5Memorial Sloan-Kettering Cancer Center, New York, USA
6Hospital Universitario de Salamanca, IBSAL, CIBERONC, Centro de Investigación
del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spanien
7Virgen del Rocío University Hospital, Sevilla, Spanien
8Princess Margaret Cancer Centre, Toronto, Kanada
9Medizinische Universität Wien, Wien, Österreich
10Universität Montpellier, Montpellier, Frankreich
11National Cancer Center Hospital, Tokyo, Japan
12Medizinische Klinik III, Klinikum der Universität, LMU München, Munich,
Deutschland
13Washington University School of Medicine in St. Louis, St. Louis, USA
14Hôpital Lyon Sud, Lyon, Frankreich
1514University College London Hospitals NHS Foundation Trust - University
College Hospital, London, United Kingdom
16Hokkaido University Hospital, Sapporo, Japan
17Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italien
18Massachusetts General Hospital Cancer Center, Boston, USA
19Maisonneuve-Rosemont Hospital, Montréal, Kanada
20Karolinska Institutet and University Hospital, Karolinska Comprehensive
Cancer Center, Stockholm, Schweden
21Bristol Myers Squibb, San Francisco, USA
22Bristol Myers Squibb, Princeton, USA
23Bristol Myers Squibb, Seattle, USA
24Celgene International Sàrl, a Bristol-Myers Squibb Company, Boudry, Schweiz
25The University of Texas MD Anderson Cancer Center, Houston, USA
Background: TRANSCEND FL (NCT04245839), a phase 2, single-arm,
multicohort, pivotal study, assessed ecacy/safety of liso-cel (anti-CD19
CAR T cell therapy) in pts with R/R indolent NHL (iNHL).
Methods: Pts with R/R FL were third-line or later (3L+) and 2L pts with
disease progression within 24 mo (POD24 and mGELF). Pts received ≥
1 prior combination systemic therapy (incl. an anti-CD20 antibody and
alkylator); and liso-cel (100 × 106 CAR+ T cells) aer lymphodepleting
chemotherapy. Bridging therapy was allowed. Primary/secondary end-
points: ORR per independent review committee by PET/CT; CR rate,
duration of response (DOR), PFS, OS, safety.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 143
Result: At cuto (Jan 27, 2023), 130/139 (94%) leukapheresed pts received
liso-cel, 5 received nonconforming product, and 124 (89%) were ecacy
evaluable (EE). In 3L+ FL pts: median (range) age was 62 y (23–80);
89% had Ann Arbor stage III/IV disease; high risk FLIPI, 57%. 43%
had POD24, 53% met GELF criteria, and 64% were double refractory to
anti-CD20 antibody and alkylator. Median (range) prior lines of therapy
was 3 (2–10). Median (range) follow-up was 18.9 mo (0.3–28.2). In 3L+
FL EE pts (n = 101), the primary endpoint was met at ORR 97.0% (95%
CI, 91.6–99.4; one-sided P < 0.0001). CR rate was 94.1% (95% CI, 87.5–
97.8; one-sided P < 0.0001). Median DOR/PFS were not reached (median
follow-up: 16.6 mo/17.5 mo); 12-mo DOR/PFS were 81.9%/80.7%.
Results were similar in 2L+ FL EE pts. In the safety set (2L+ FL, n=130),
most common grade (G) ≥ 3 treatment-emergent adverse events (TEAEs)
were cytopenias; most frequently neutropenia (65%). One TEAE death
occurred (G5 macrophage activation syndrome). Cytokine release syn-
drome (CRS) occurred in 58% (G3, 1%; no G4–5) and neurological events
(NE) in 15% (G3, 2%; no G4–5). Prolonged cytopenia (G≥ 3 laboratory
values at day 29) occurred in 22% and G≥ 3 infection in 5%.
Discussion: Liso-cel provided high, durable response with low G≥ 3
TEAE rates.
Conclusion: In pts with R/R FL, liso-cel showed clinically meaningful
benet and favorable safety.
First published: Morschhauser F et al. Hematol Oncol 2023;41[S2]:LBA4.
Disclosure Statement: e authors declare that there are conicts of interest.
econicts were submitted to the congress organizer KUKM GmbH and KUKM
can disclose them if needed.
267
Novel MACC1 transcriptional inhibitors for anti-metastatic
personalized therapy for high risk patients
Paul Curtis Schöpe1; Shixian Yan1; Joe Lewis2; Kerstin Putzker2;
Ulrike Uhrig2; Specker Edgar3; Von Kries Jens Peter3; Mathias Dahlmann1,4;
Janice Smith1; Hector E Sanchez-Ibarra1; Unger Anke5;
Mia-Lisa Zischinsky5; Bert Klebl5; Wolfgang Walther1,4; Anahid Omran3;
Marc Nazaré3; Dennis Kobelt1,4; Ulrike Stein1,4
1Experimental and Clinical Research Center, Charité – Universitätsmedizin
Berlin, and Max-Delbrück-Center for Molecular Medicine, Berlin, Deutschland
2The European Molecular Biology Laboratory, EMBL, Heidelberg, Deutschland
3Leibniz-Forschungsinstitut für Molekulare Pharmakologie, FMP, Berlin,
Deutschland
4German Cancer Consortium (DKTK Partnersite Berlin), Deutsches
Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
5Lead Discovery Center, LDC, Dortmund, Deutschland
Background: Metastasis formation is the leading cause of death in
colorectal cancer, oen caused by insucient therapies. Compounds
able to interfere with metastasis formation are desperately needed. In this
study, novel small molecules were identied and characterized which tar-
get the expression of MACC1 (Metastasis Associated in Colon Cancer 1).
MACC1 has been established as a key molecule for tumor progression and
metastasis formation in colorectal cancer (CRC) and more than 20 solid
tumor entities.
Methods: A high-throughput screen was conducted at the EMBL,
Heidelberg using a MACC1 promoter luciferase construct transfected into
HCT116 cells. All compounds were evaluated for their inhibition on tran-
scription by quantitative RT-PCR (qRT-PCR) and Western Blots in CRC
and other entity cell lines. Cell motility was evaluated using wound heal-
ing and Boyden chamber assay. In vivo experiments were conducted using
a HCT116 CDX tumor model. Characteristics were evaluated by ADMET
studies at the LDC GmbH. RNA-sequencing and analysis explored the
mode of action of these novel compounds.
Result: Tetrazolo-pyridazine-harboring Compound 22 and analogues
were identied as promising transcriptional inhibitors of MACC1.
ese compounds eectively inhibit MACC1 gene expression lead-
ing to a reduction of cell motility in vitro in CRC and cross entity cell
lines. Furthermore, they inhibit MACC1-induced tumor progression and
metastasis in vivo. Our ADMET studies conrmed drug-likeness of the
compounds with high stability in human plasma and great permeabil-
ity. RNA-sequencing revealed an immune pathway which is likely to be
altered by the compounds.
Discussion: We demonstrated that our novel compounds are eective
transcriptional inhibitors of MACC1. Further, they restrict MACC1
driven cell motility in vitro and tumor progression and metastasis for-
mation in vivo. ADMET studies conrm drug-likeness and favorable
characteristics.
Conclusion: Taken together, this novel class of small molecules represents
promising candidates for personalized anti-metastatic therapy.
Disclosure Statement: e authors declare no conict of interest.
297
The Ligase IV Inhibitor SCR130 has Limited Radiosensitizing
Potential in Head and Neck Cancer Cell Lines
Laura S. Hildebrand; Rainer Fietkau; Luitpold Distel
Universitätsklinikum Erlangen, Strahlenklinik, Erlangen, Deutschland
Background: Radiation sensitivity could be improved by small molecule
inhibitors that interfere with DNA double-strand break repair (DDBR).
We inhibited (Ligase IV inhibitor SCR130) one of the main DDBR mech-
anisms Non-homologous end joining because it is oen the only unmu-
tated DDBR possibility in tumor cells. Healthy cells instead have the
advantage of other available DDBR pathways.
Methods: HNSCC cell lines and healthy broblasts were treated 48 h
with 30 µM SCR130 and where required additionally with a single dose
of 2 Gy 3 h aerwards. Dividing cells were determined by the colony for-
mation assay. Cell death (apoptosis: Annexin V, necrosis: 7-AAD) and
cell cycle distribution (Hoechst) were measured with ow cytometry.
Immunostaining was used to investigate the quantity of γH2AX, Ki67 and
Ligase IV in the cells.
Result: e surviving fraction in the colony formation assay decreased in
only 2 of 7 HNSCC cell lines signicantly in the combined treatment (30
µM SCR130 + 2 Gy) compared to irradiation (2 Gy). In 4 of 7 HNSCC
cell lines the combined treatment resulted in a signicant increase of dead
cells compared to irradiation (e.g. UD-SCC-2 from 27 % to 87 %). e
number of cells in G0/G1 phase was increased signicantly by the com-
bination compared to irradiation in 4 of 7 HNSCC cell lines, whereas it
decreased in broblasts. e correlation of Ligase IV in the cell and the
surviving fraction suggested that more Ligase IV in untreated cells results
in a stronger reaction to the combined treatment.
Discussion: e Ligase IV Inhibitor SCR130 leads to increased radiation
sensitivity in some HNSCC cell lines and inuences their cell cycle dis-
tribution even if the eects especially regarding clonogenicity are slight.
Further experiments are necessary to determine cell cycle checkpoints,
cell line specic dierences and escape mechanisms.
Conclusion: e Ligase IV inhibitor SCR130 has limited radiosensitizing
potential in HNSCC cell lines which is surprising considering the vital
role of Ligase IV in DDBR.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts144
334
Idecabtagene vicleucel (ide-cel) vs standard regimens in
patients (pts) with triple-class-exposed (TCE) relapsed and
refractory multiple myeloma (RRMM): a KarMMa-3 analysis in
high-risk subgroups
Marc S Raab1; Krina Patel2; Paula Rodríguez-Otero3; Salomon Manier4;
Rachid Baz5; Michele Cavo6; Natalie Callander7; Luciano J. Costa8;
Philippe Moreau9; Scott R. Solomon10; Christine Chen11; Noopur Raje12;
Christoph Scheid13; Michel Delforge14; Jeremy Larsen15; Thomas Pabst16;
Kenshi Suzuki17; Anna Truppel-Hartmann18; Julia Piasecki19;
Jasper Felten19; Andrea Caia19; Mark Cook19,20; Sergio Giralt21;
Maria-Victoria Mateos22
1Universitätsklinikum Heidelberg, Heidelberg, Deutschland
2MD Anderson Cancer Center, The University of Texas, Houston, USA
3Clinica Universidad de Navarra, Pamplona, Spanien
4Centre Hospitalier Universitaire de Lille, Université de Lille, Lille, Frankreich
5Mott Cancer Center, Tampa, FL, USA
6IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of
Hematology and the Department of Experimental, Diagnostic, and Specialty
Medicine, Bologna University School of Medicine, Bologna, Italien
7University of Wisconsin Carbone Cancer Center, Madison, USA
8University of Alabama at Birmingham, Birmingham, USA
9University Hospital of Nantes, Nantes, Frankreich
10Northside Hospital Cancer Institute, Atlanta, USA
11Princess Margaret Hospital, Toronto, Kanada
12Massachusetts General Hospital, Boston, USA
13Uniklinik Köln, Köln, Deutschland
14Universitaire Ziekenhuizen, Leuven, Belgien
15Mayo Clinic Arizona, Phoenix, USA
16University Hospital Inselspital and University of Bern, Bern, Schweiz
17Japanese Red Cross Medical Center, Tokyo, Japan
182seventy bio, Cambridge, MA, USA
19Bristol Myers Squibb, Princeton, USA
20Institute of Cancer and Genomic Sciences, University of Birmingham,
Birmingham, United Kingdom
21Memorial Sloan Kettering Cancer Center, New York, USA
22Hospital Clínico Universitario de Salamanca, Salamanca, Spanien
Background: Ide-cel improved median progression-free survival (mPFS)
and overall response rates (ORRs) vs standard (std) regimens in pts with
TCE RRMM in KarMMa-3 (NCT03651128). Here we show the ecacy of
ide-cel vs std regimens in pts with high-risk (HR) disease in KarMMa-3.
Methods: In KarMMa-3, pts with RRMM with 2–4 prior regimens, TCE
disease, and refractoriness to the last regimen were randomized 2:1
to receive ide-cel or a std regimen. Ecacy (PFS, ORR, and complete
response rate [CRR]) was assessed in HR groups including pts with cyto-
genetic abnormalities, R-ISS stage III disease, high tumor burden, extra-
medullary plasmacytomas (EMPs), and triple-class refractory (TCR)
disease.
Result: Baseline demographics and HR disease characteristics were bal-
anced between treatment arms. Median time to progression on the last
prior regimen was short in pts treated with both ide-cel vs std regimens in
all HR subgroups: cytogenetic abnormalities (5.6 vs 6.7 mo), R-ISS stage
III disease (3.9 vs 3.5 mo), high tumor burden (5.1 vs 6.2 mo), EMP (5.1
vs 5.1 mo), and TCR disease (5.6 vs 5.8 mo).
At a median follow-up of 18.6 (0.4–35.4) mo, mPFS was longer in pts
treated with ide-cel vs std regimens in all HR subgroups: cytogenetic
abnormalities (11.9 vs 4.2 mo), R-ISS stage III disease (5.2 vs 3.0 mo),
high tumor burden (11.0 vs 4.9 mo), EMP (7.2 vs 2.0 mo), and TCR dis-
ease (11.2 vs 3.5 mo). ORRs were improved with ide-cel vs std regimens,
regardless of the presence of HR disease. Similarly, CRRs were improved
in pts treated with ide-cel vs std regimens in all HR subgroups: cytoge-
netic abnormalities (31.8 vs 4.9%), R-ISS stage III (16.1 vs 7.1%), high
tumor burden (31.0 vs 8.8%), EMP (23.0 vs 3.1%), and TCR disease (33.5
vs 1.1%).
Discussion: Pts treated with ide-cel had lower risk of disease progression
or death and higher odds of achieving an overall response (with higher
CRRs) compared with pts who received std regimens, regardless of base-
line HR disease.
Conclusion: ese results support use of ide-cel in pts with TCE RRMM,
including pts with HR disease.
First published: Patel K et al. HemaSphere 2023;7[S3]:S195.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
358
ARTIC -Abscopal eects in metastasized cancer patients
treated withradiotherapy andimmunecheckpoint inhibition-
Preliminary results of a large observational multicenter study
of the young DEGRO
Maike Trommer1,2,3; Alexander Rühle4,5; Allison Lamrani6;
Charlotte Schmitter6; Justus Kaufmann7; Matthias Mäurer8,9;
Georg Wurschi8,10; Ping Jiang11; Felix Ehret12; Andrea Baehr13;
Annika Hardt14; Raphael Bodensohn15,16; Lukas Käsmann15;
Danny Jazmati17; Sebastian Neppl1; Anna Hagemeier18; Simone Wegen1
1Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of
Medicine and University Hospital Cologne, Cologne, Deutschland
2Department of Radiation Oncology, Olivia Newton-John Cancer Wellness &
Research Centre, Austin Health, Melbourne, Australien
3Center for Molecular Medicine Cologne (CMMC), Cologne, Deutschland
4Department of Radiation Oncology, Medical Center – University of Freiburg,
Faculty of Medicine, University of Freiburg, Freiburg, Deutschland
5Department of Radiation Oncology, University of Leipzig, Leipzig, Deutschland
6University Hospital Erlangen, Department of Radiation Oncology, Erlangen,
Deutschland
7Department of Radiation Oncology, University Medical Center of the Johannes
Gutenberg University, Mainz, Deutschland
8Department of Radiation Oncology, University Hospital Jena, Jena,
Deutschland
9Clinician Scientist Programm OrganAge, University Hospital Jena, Jena,
Deutschland
10Clinician Scientist Program, IZKF, Jena University Hospital, Jena, Deutschland
11Department of Radiation Oncology and Radiotherapy, Pius Hospital
Oldenburg, University Medicine Oldenburg, Oldenburg, Deutschland
12Department of Radiation Oncology, Charité - Universitätsmedizin Berlin,
corporate member of Freie Universität Berlin and Humboldt Universität zu
Berlin, Berlin, Deutschland
13Department of Radiation Oncology, Medical Hospital Hamburg-Eppendorf,
Hamburg, Deutschland
14Outpatient Center of the University Medical Hospital Hamburg-Eppendorf,
Department of Radiotherapy and Radiation Oncology, Hamburg, Deutschland
15Department of Radiation Oncology, University Hospital, LMU Munich, Munich,
Deutschland
16Department of Radiation Oncology, University Hospital Tübingen, Tübingen,
Deutschland
17Department of Radiation Oncology, University Hospital Dusseldorf, Medical
Faculty, Heinrich-Heine-University Dusseldorf, Dusseldorf, Deutschland
18Institute of Medical Statistics and Computational Biology, Medical Faculty,
University of Cologne, University Hospital Cologne, Cologne, Deutschland
Background: Abscopal eects (AbE) are characterized by regression of
non-irradiated lesions (NIL) following radiotherapy (RT). eir induc-
tion is of interest for patients with progressive disease (PD) during
immune checkpoint inhibition (ICI), as AbE are likely immune-mediated.
e actual incidence in the RT-ICI setting is unclear.
Methods: Records were screened for patients receiving RT for PD of
metastatic cancer during ICI between 2015-21. Eligible patients had ≥1
NIL outside the 10% RT isodose. Patients switching systemic treatment
within radiological response assessment (RA) were excluded. Up to 5 NIL
were measured. Size reduction ≥30% was rated abscopal response (AR),
increase by ≥20% abscopal progression (AP). Sample size calculation was
based on an assumed AbE rate of 20% and required inclusion of 62 cases
with 10% precision (CI10-30%).
Result: We analyzed preliminary data from 8 participating centers.
3381 cases were screened to identify 98 eligible patients. Median
FU was 12 months. Lung cancer (n=32, 33%) and melanoma (n=30,
31%) were most frequent cancer types, nivolumab (n=48, 49%) most
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 145
frequent ICI, and hypofractionated (n=55, 56%) the most frequent
RT type. At final RA within 6 months, 59 (60%) patients showed
response to RT-ICI. 170 NIL from 95 patients could be included for
AbE assessment: 47 NIL (28%) showed AR, 96 (56%) were stable, 27
(16%) showed AP. On patient level, 34 (36%) had ≥1NIL with AR and
14 (15%) had AR of all NIL.
Discussion: is is the rst analysis of AbE following concurrent RT for
PD during ICI treatment in a large multicenter cohort. Our results are in
line with case series reporting 18-52% AR. Strengths of this study include
the multicentric design and meaningful sample size. Subgroup analyses,
predictors of AbE and survival outcomes are underway.
Conclusion: RT during ICI induced AbE in one third of progressing or
stable lesions outside the RT eld. More than half of the patients showed
response to treatment while 15% had response in all NIL. Our data sug-
gest synergy between RT and ICI and serve as reference for designing pro-
spective trials evaluating AbE.
Disclosure Statement: e authors declare no conict of interest.
418
Cost-eectiveness analysis of transplant-ineligible relapsed/
refractory diuse large B cell lymphoma interventions:
Results from the German eciency frontier approach
Melina Sophie Kurte1,2; Ann-Cathrine Siefen2; Florian Jakobs3; Bastian von
Tresckow4; Christian Reinhardt3; Florian Kron2,5,6,7
1Faculty of Medicine, University of Duisburg-Essen, Essen, Deutschland
2VITIS Healthcare Group, Cologne, Deutschland
3Department of Haematology and Stem Cell Transplantation, Faculty of
Medicine and University Hospital Essen, University of Duisburg-Essen, Essen,
Deutschland
4Department of Haematology and Stem Cell Transplantation, West German
Cancer Center and German Cancer consortium (DKTK partner site Essen),
University Hospital Essen, University of Duisburg-Essen, Essen, Deutschland
5Department I of Internal Medicine, Faculty of Medicine and University Hospital
Cologne, University of Cologne, Cologne, Deutschland
6Center for Integrated Oncology (CIO ABCD), Faculty of Medicine and University
Hospital of Cologne, University of Cologne, Cologne, Deutschland
7FOM University of Applied Sciences for Economics and Management, Essen,
Deutschland
Background: Recently, treatment of transplant-ineligible relapsed/refrac-
tory (r/r) diuse large B cell lymphoma (DLBCL) changed remarkably.
Since 2018, the European Medicines Agency has approved CAR-T thera-
pies (axicabtagene ciloleucel [axi-cel], lisocabtagene maraleucel [liso-cel],
tisagenlecleucel [tisa-cel]), and targeted therapies (polatuzumab-benda-
mustine-rituximab [pola-BR], tafasitamab-lenalidomide [Tafa-L]). In
Germany, innovative drugs are priced according to their additional benet
contrasted to current standard-of-care. To compare the cost-eectiveness
ratios of third-line and beyond (3+L) interventions for transplant-ineligi-
ble r/r DLBCL, an eciency frontier (EF) analysis was conducted from a
healthcare payer perspective.
Methods: Following the methods of the German Institute for Quality
and Efficiency in Healthcare (IQWiG), a systematic literature review
was performed to assess clinical benefit based on median overall sur-
vival (mOS) of axi-cel, liso-cel, tisa-cel, pola-BR, Tafa-L, and ritux-
imab-gemcitabine-oxaliplatin (R-GemOx) in 3+L DLBCL. First-year
treatment costs were calculated. Treatment costs and mOS values were
plotted in one EF graph. Sensitivity analyses using Monte Carlo sim-
ulations were performed to verify point estimates of clinical benefit
values.
Result: e EF is built by R-GemOx (€29,080, mOS 12 months), Tafa-L
(€104,541, 15.5 months), and axi-cel (€308,516, 18.69 months). High
uncertainty was found for mOS of axi-cel and liso-cel. e highest
increase in value per euro is gained for Tafa-L.
Discussion: In the current treatment of transplant-ineligible r/r DLBCL,
R-GemOx, Tafa-L, and axi-cel form the cost-eectiveness threshold uti-
lized for pricing decisions of newly approved drugs, which must meet
this threshold to be rated as cost-eective. is could come into eect for
pricing decisions of loncastuximab tesirine or glotamab.
Conclusion: e EF is one element in a holistic cost-benet evaluation
and is to be understood as a dynamic tool, which may change if innova-
tion shis are obtained.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
482
Preconditions for a frictionless CAR-T therapy
process - AGroup Concept Mapping analysis
Ann-Cathrine Siefen1; Melina Sophie Kurte1,2; Florian Kron1,3,4,5
1VITIS Healthcare Group, Cologne, Deutschland
2Faculty of Medicine, University of Duisburg-Essen, Essen, Deutschland
3Department I of Internal Medicine, Faculty of Medicine and University Hospital
Cologne, University of Cologne, Cologne, Deutschland
4Center for Integrated Oncology (CIO ABCD), Faculty of Medicine and University
Hospital of Cologne, University of Cologne, Cologne, Deutschland
5FOM University of Applied Sciences, Essen, Deutschland
Background: Chimeric antigen receptor T-cell (CAR-T) therapy is an
innovative cancer therapy starting in Europe with its rst approvals in
2018. However, CAR-T therapy poses major logistical and organizational
challenges for involved stakeholders. Additionally, there are nancial
constraints due to the reimbursement of a one-time therapy and high
qualitative requirements for the CAR-T centers. us, the aim was to sys-
tematically assess the procedural challenges in CAR-T therapy and iden-
tify preconditions for a frictionless process.
Methods: A Group Concept Mapping (GCM) analysis, a mixed methods
participatory research method, was conducted in two phases. In phase 1,
participants collected statements completing the following focus prompt:
To ensure that the CAR-T cell therapy process - from initial indication to
follow-up - runs as frictionless as possible, it takes ...?”. In Phase 2, partic-
ipants were asked to a) group statements based on similarity and b) rate
their importance and feasibility. Multivariate analyses were depicted in
a cluster (or concept) map reecting the main topics. Results were com-
bined with calculated average ratings.
Result: Participants consisted of CAR-T experts from dierent profes-
sions. 11 + x (Adboard + remote contributions) participants completed
phase 1 collecting 214 and x statements, respectively (x nal statements
aer data cleansing). In phase 2, x participants rated and sorted the state-
ments generating a concept map consisting of the x following clusters
(from highest to lowest average importance rating): x, x, x, and x.
Discussion: is is the rst German mixed-methods study capturing pre-
conditions for reducing hurdles in the CAR-T therapy process. It reects
various perspectives and allows prioritizing the collected preconditions
based on their perceived importance and feasibility.
Conclusion: Future eorts should focus on providing the identied
preconditions for a frictionless process, starting with high-priority
aspects. Structured cost analyses could quantify the eort required for its
implementation.
Disclosure Statement: e authors declare the following: A-C Siefen, MS Kurte,
and F Kron are employees of the VITIS Healthcare Group, which was sponsored
by GILEAD Sciences GmbH in connection with the development of the study. e
funder of the study had no role in study design, data analysis, or data interpreta-
tion and writing of the abstract.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts146
583
Pseudoprogression in multiple myeloma patients treated with
Anti-BCMA CAR-T cells
Max Topp; Sven Schimanski; Hannah Hornburger; Sophie Kadel;
Hermann Einsele; Leo Rasche; Johannes Düll
Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg,
Deutschland
Background: Immunotherapy of relapsed/refractory multiple myeloma
(RRMM) patients with anti-BCMA CAR-T cells results in an objective
response rate of up to 95%. Incidence, presentation, management and out-
come of pseudoprogression aer CAR-T infusion has not been reported
in RRMM patients.
Methods: RRMM patients treated with either Ide-Cel or Citla-Cel aer
CAR-T infusion were followed for pseudoprogression aer CAR-T
infusion.
Result: 44 RRMM patients were infused with either commercially available
CAR-T cells; Ide-Cel (n=36) or Citla-Cel (n=8); between November 2021
and August 2023. 3 out of 46 patients (6.5%) developed clinical and imag-
ing signs of pseudoprogression (bone pain and FDG PET/MRI positivity)
on day 1,3 and 5 respectively. In two patients, biopsies showed a massive
inux of activated CAR-T cells with no myeloma cells present at the site.
Interestingly, the peak of pain coincides with the peak of CAR-T expansion
in peripheral blood. e pain was treated with morphine for 5,2 and 3 days
and dexamethasone once in one patient to control symptomatic and to stop
local cytokine production. Pain resolved and medication was completely
tapered in one patient, two continued low dose Hydromorphon for about 2-4
weeks. All 3 subjects achieved a MRD negative CR at month 3 and remain
in remission.
Discussion: is is the rst report on the incidence and management of
pseudoprogression in RRMM patients treated with anti-BCMA CAR-T
whereby pseudoprogression appears to have a similar incidence in RRMM
as in NHL patients1 treated with CAR-T.
Conclusion: Pseudoprogression is not uncommon in RRMM treated with
anti-BCMA CAR T cells and can be successfully managed with painkillers
and steroids without aecting the response.
Reference:
1. Immune imitation of tumor progression aer anti-CD19 chimeric antigen
receptor T cells treatment in aggressive B-cell lymphoma. Ivetta Danylesko
et al. Bone Marrow transplantation 56:1134–1143, 2021.
Disclosure Statement: e authors declare no conict of interest.
595
Eectiveness of dierent oncolytic vaccinia virus strains for
the in vitro and in vivo treatment of peritoneal mesothelioma
Can Yurttas1,2; Julia Beil2,3,4; Berchtold Susanne2,3; Irina Smirnow2,3;
Linus D. Kloker2,3; Bence Sipos3,4,5; Alfred Königsrainer1,4; Andre Mihaljevic1;
Ulrich Lauer2,3,4; Karolin Thiel1
1Department of General, Visceral and Transplant Surgery, University Hospital of
Tübingen, Tübingen, Deutschland
2Virotherapy Center Tübingen (VCT), Department of Medical Oncology and
Pneumology, University Hospital of Tübingen, Tübingen, Deutschland
3Department of Internal Medicine VIII, Medical Oncology and Pneumology,
University Hospital of Tübingen, Tübingen, Deutschland
4German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ),
Partner Site Tübingen, Tübingen, Deutschland
5BAG für Pathologie und Molekularpathologie Stuttgart, Stuttgart, Deutschland
Background: Eective treatment for peritoneal surface malignancies
(PSM) is scarce. Oncolytic virotherapy with recombinant vaccinia viruses
might constitute a novel treatment option for PSM. We aimed to identify
the most eective oncolytic vaccinia virus strain in two murine mesotheli-
oma cell lines and the oncolytic potential in a murine model of peritoneal
mesothelioma.
Methods: Cell lines AB12 and AC29 were infected in vitro with vaccinia
virus strains Lister (GLV-1h254), Western Reserve (GLV-0b347) and
Copenhagen (GLV-4h463), kindly provided by Genelux, Westlake Village,
California, USA. Feasibility, safety and eectiveness of intraperitoneal
virotherapy were assessed by determination of the peritoneal cancer index
(PCI), virus detection in tumor tissues and ascites, virus growth curves
and comparison of overall survival in mesothelioma-bearing mice.
Result: Oncolytic vaccinia virus strain GLV-0b347 was found to be most
eective in terms of oncolysis and viral replication in both murine cell
lines AB12 and AC29. Aer i.p. injection of GLV-0b347, virus was detect-
able in tumors and ascites aer 24 and 48 h post infection, overall sur-
vival was signicantly prolonged, and development of ascites and PCI was
decreased (in comparison to mock-treated mice) whereas no viral spread
to the blood or brain was detected. e observations made were found to
depend on the amount of tumor cells and the time from tumor implanta-
tion to virus application.
Discussion: Vaccinia virus strain GLV-0b347 was identied to be most
eective in vitro. In vivo, this Western Reserve virus strain was frequently
detectable in tumors and ascites of virus-treated mice enabling signi-
cantly prolonged animal survival. Next, treatment modications and
combinational therapy approaches will be investigated to further enhance
eectiveness.
Conclusion: Intraperitoneal virotherapy using vaccinia virus construct
GLV-0b347 was shown to be feasible, safe and eective when treating
peritoneal mesothelioma in a murine model.
Disclosure Statement: e authors declare no conict of interest.
625
Stearoyl-CoA desaturase in CD4+ T cells suppresses tumor
growth through activation of CXCR3/CXCL11-axis in CD8+
Tcells
yongbaek kim
College of Veterinary Medicine, Seoul National University, Seoul, Republik Korea
Within tumor microenvironment, altered lipid metabolism promotes can-
cer cell malignancy via activation of oncogenic cascades, but its impact
on the tumor-inltrating lymphocytes (TILs) remains poorly understood.
Here, we demonstrated that treatment with CAF-supernatant enhanced
the expression of stearoyl-CoA desaturase (SCD) and increased the pro-
duction of oleic acid (OA) in CD4+ T cells under glucose-decient con-
dition. Enhanced SCD promoted the dierentiation of Jurkat cells toward
1 cells with increased expression of T-bet, IL-2, and IFN-γ. In contrast,
inhibition of SCD upregulated the expression of regulatory T (Treg) cell
markers, Foxp3 and TGF-β. Comparative fatty acid analysis of genetically
engineered Jurkat cells revealed that OA was signicantly higher in SCD-
overexpressed cells. Meanwhile, saturated fatty acid like palmitic acid (PA)
was more prevalent in SCD-KO cells with upregulated mitochondrial
superoxide. Indeed, the expression of markers for 1 and Treg cells were
regulated by treatment with OA or PA, respectively. Furthermore, SCD
conferred a secretion of C-X-C motif chemokine ligand 11 (CXCL11)
from CD4+ T cells. Binding of CXCL11 with C-X-C chemokine receptor 3
(CXCR3) on CD8+ T cells augmented their cytotoxic activity and CXCR3
expression. In mouse tumor model, suppressive eect of CD8+ T cells on
tumor growth was dependent on CXCR3 expression. ese ndings illus-
trated that the SCD not only orchestrated dierentiation of T helper cells
but also promoted the antitumor activity of CD8+ T cells, suggesting its
function in adverse tumor microenvironment.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 147
676
Successful treatment with chimeric antigen receptor (CAR)
T-lymphocytes of an adult patient with relapsed and
refractory (r/r) Philadelphia Chromosome (Ph) positive acute
lymphoblastic leukemia (ALL) after allogeneic hematopoietic
stem-cell transplantation (allo-HSCT) - a case report
Sebastian Wegener1; Olaf Hopfer2; Georg-Nikolaus Franke1;
Madlen Jentzsch1; Michael Kiehl2; Uwe Platzbecker1; Vladan Vucinic1
1University Leipzig Medical Center, Department for Hematology, Cell therapy,
Hemostaseology and Infectious Diseases, Leipzig, Deutschland
2Department of Internal Medicine I, Frankfurt (Oder) General Hospital,
Frankfurt/Oder, Deutschland
Background: e prognosis of patients (pts) with r/r Ph+ ALL is unfa-
vorable, especially when relapsing aer allo-HSCT with limited thera-
peutic options. CAR-T cell treatment is a promising option, but the data
regarding CAR-T in post allo-HSCT pts is limited.
Methods: Hematologic response was assessed according to current guide-
lines. Here we present a case of a 44-year-old Caucasian male pt with Ph+
ALL successfully treated with CAR-T cells aer prior allo-HSCT.
Result: e pt presented in September 2022 with Ph+ common B-ALL.
He was diagnosed 2017 and treated according to the German ALL proto-
col with imatinib, two inductions and one consolidation chemotherapy,
followed by an allo-HSCT from matched unrelated donor. e treatment
led to complete remission (CR) without measurable residual disease
(MRD). In 2019, BCR::ABL1 was again detected and due to a resistance
mutation, the pt was treated with dasatinib and donor lymphocyte infu-
sions (DLI) were applied, without eect on the BCR::ABL1 burden. In
September 2022, he relapsed with 26% blasts in peripheral blood. Aer
three courses of inotuzumab-ozogamicin the pt was in MRD-positive CR
and underwent treatment with brexucabtagene-autoleucel (brexu-cel).
He developed cytokine release syndrome grade 2 and immune eector
cell associated neurotoxicity syndrome grade 3 shortly aer reinfusion
and both complications resolved completely. 15 days aer reinfusion,
bone marrow smear showed CR with a relevant decrease of MRD, and
three months aer, MRD-negative CR and a 100% donor chimerism. Six
months aer brexu-cel the pt underwent a 2nd allo-HSCT and is cur-
rently, three months aerwards, in ongoing MRD-negative CR without
signs of gra-vs- host disease.
Discussion: Brexu-cel is an eective and promising new therapeutic
option in the treatment of r/r ALL also in pts aer previous allo-HSCT.
Conclusion: Our heavily pretreated r/r pt achieved an MRD-negative
CR 3 months aer reinfusion. Further trials are necessary to dene the
denitive curative potential of CAR T treatment in r/r ALL pts, esp. aer
previous allo-HSCT.
Disclosure Statement: e authors declare the following: UP and VV: Honoraria
from BMS-Celgene, Novartis, Gilead/Kite, Janssen; Travel Grants from: Janssen,
BMS-Celgene, Gilead/Kite. MJ: Honoraria Novartis, BMS/Celgene. GNF: Hono-
raria Novartis, Gilead/Kite. MK, OH and SW have nothing to disclose.
688
Treatment of patients with ALL or NHL with third-generation
CD19-directed chimeric antigen receptor (CAR) T cells –
updated results of the Heidelberg trial 1 (HD-CAR-1 trial)
Maria-Luisa Schubert1; Anita Schmitt1; Simon Haas2; Patrick Derigs1;
Schayan Yousean2; Felix Korell1; Tim Sauer1; Anthony D. Ho1;
Carsten Müller-Tidow1; Peter Dreger1; Michael Schmitt1
1Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg,
Deutschland
2BIH - Charité, Berlin, Deutschland
Background: ird-generation chimeric antigen receptor (CAR)-
engineered T-cells (CARTs) might improve clinical outcome of patients
with B-cell malignancies. Here we report a phase-1/2 investigator-initiated
trial (HD-CAR-1) on a third-generation CART dose-escalating, treating
adult patients with acute lymphoblastic leukemia (ALL) or non-Hodgkins
lymphoma (NHL).
Methods: HD-CAR-1 is designed to evaluate escalating doses of
third-generation (CD28 and 4-1BB (CD137) costimulatory domains)
CD19-directed CARTs (1×106 to 2×108 CARTs/m2) aer lymphodepletion
with udarabine and cyclophosphamide. Leukapheresis, manufacturing
and administration of CARTs, patient monitoring and follow-up are per-
formed in-house at the GMP Core Facility of the Heidelberg University
Hospital. In addition to r/r NHL patients, adult patients with r/r ALL are
eligible.
Results:40 patients with r/r ALL or r/r NHL were enrolled. Patients had
received a median of 4 (range 2 to 9) prior treatment lines, including allo-
geneic stem cell transplantation (alloSCT). For all patients, CART manu-
facturing was feasible. Patients were treated with 1 to 200 million CART
cells/sqm. None of the treated patients developed any grade of immune
eector cell-associated neurotoxic syndrome (ICANS) or a higher-grade
(≥ grade III) cytokine release syndrome (CRS).
Response and outcome were associated with the administered CART dose.
At 3-year-follow-up, overall survival (OS)/progression free survival (PFS)
was 70%/50 % and 50%/25% for NHL and ALL patients, respectively.
Lack of CD39-expression on memory-like T cells was more frequent
in CART products of responders when compared to CART products of
non-responders. Aer CART administration, higher CD8 + and γδ-T cell
frequencies, a physiological pattern of immune cells and lower monocyte
counts in the PB were associated with response.
Conclusions: In conclusion, third-generation CARTs were associated
with promising clinical ecacy and remarkably. Responders displayed
higher frequencies of a specic memory-like T cell subset within the
CART-product.
Disclosure Statement: e authors declare the following: Unrestricted grants from
Kite/Gilead, Novartis, BMS and Janssen.
697
Ciltacabtagene autoleucel compared to standard of care in
triple-class exposed multiple myeloma: combined analyses
of adjusted comparison of CARTITUDE-1 and prospective
real-world cohort LocoMMotion with data from the
randomized controlled trial CARTITUDE-4
Christina Schulat1; Janine Jakobs1; Ronja Kerßenboom2; Joris Diels3;
Francesca Ghilotti3; Pushpike Thilakatathne3; Jedelyn Cabrieto3;
Nolen Joy Perualila3; Sandra van Hoorenbeeck3; Lewin Eisele2;
Andreas Blees2; Jörn Sindern2; Christof Scheid4
1Janssen-Cilag GmbH, Neuss, Deutschland
2Janssen-Cilag GmbH, Neuss, Deutschland
3Janssen Pharmaceutica, Beerse, Belgien
4Uniklinik Köln, Köln, Deutschland
Background: Ciltacabtagene autoleucel (ciltacel) is currently indicated
for patients with multiple myeloma (MM) who received at least three
prior lines of therapy, are triple-class exposed and refractory to last line
of therapy (in-label population). is analysis aims to assess the overall
survival (OS) of the in-label population treated with ciltacel compared to
standard of care (SoC) and was conducted to address the requirements of
the German health technology assessment (HTA).
Methods: e Phase 1b/2 single-arm trial CARTITUDE-1 enrolled 124
in-label patients. CARTITUDE-4 is a Phase 3 randomized controlled trial
(RCT) comparing ciltacel to two regimens of physicians choice (PC) in
patients with MM, who received one to three prior lines of therapy and
are refractory to lenalidomide. It includes a subgroup of 20 (ciltacel) vs. 29
(PC) in-label patients. LocoMMotion is a prospective real-world evidence
cohort designed as an external control arm for a target trial emulation
(TTE) with CARTITUDE-1. It enrolled 110 in-label patients, who fullled
all CARTITUDE-1 inclusion criteria and received SoC regimens consid-
ered appropriate comparator treatment (ACT) by the German HTA body.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts148
e adjusted comparison of CARTITUDE-1 and LocoMMotion was
complemented with patients from the ciltacel and the PC arms from
CARTITUDE-4, respectively. Potential confounding factors were identi-
ed systematically and adjusted for using Inverse Probability Weighting
(IPW) methods and Propensity Score Matching (PSM).
Result: Naïve comparison yielded an OS hazard ratio (HR) of 0.38 (95%
CI: 0.26, 0.56) in the in-label population. Results from IPW and PSM
approaches are highly consistent with HR ranging from 0.31 to 0.43.
Discussion: By combining the TTE with RCT data, comparability of
patient characteristics between treatment groups was increased with con-
sistent OS results. Potential confounding was addressed by IPW-methods.
PSM conrmed the positivity of the study populations.
Conclusion: e analyses provide valid results showing that ciltacel sub-
stantially prolongs OS compared to SoC.
Disclosure Statement: e authors declare the following: wirtschaliche oder
persönliche Verbindungen zu Unternehmen der Gesundheitswirtscha.
702
Tumor Treating Fields (TTFields) may be utilized to increase
temozolomide and lomustine ecacy in glioblastoma
celllines
Hila Fishman1; Roni Monin1; Eyal Dor-On1; Adi Haber1; Bastian Gastl2;
Moshe Giladi1; Uri Weinberg1; Yoram Palti1
1Novocure Ltd, Haifa, Israel
2Novocure GmbH, Munich, Deutschland
Background: Glioblastoma (GBM) is the most frequent type of primary
malignant brain tumor in adults. Temozolomide (TMZ) is standard of
care for newly diagnosed GBM (ndGBM). e lack of response to TMZ in
some patients may be attributed to the expression of MGMT, an enzyme
implicated in repairing DNA damage triggered by TMZ. Tumor Treating
Fields (TTFields) are electric elds that disrupt critical cellular process
involved in cancer cell survival and tumor progression. TTFields therapy
applied concomitantly with TMZ is an approved treatment for ndGBM.
A recent study demonstrated clinical benets of TMZ and lomustine
(CCNU) co-treatment. is study aimed to examine the eect of TTFields
concurrent with TMZ and CCNU in GBM cells.
Methods: Human GBM cells (U-87 MG, LN229, U118, LN18) with vary-
ing MGMT expression levels were subjected to TTFields (0.83 V/cm RMS,
200 kHz) together with TMZ and/or CCNU and assessed for eective-
ness using cell counts and colony formation. Additionally, the impact of
TTFields on expression of proteins from the Fanconi anemia (FA)-BRCA
DNA repair pathway was analyzed using western blot.
Result: TTFields and TMZ concomitant application demonstrated an
additive eect, independent of MGMT expression levels. e eect of
TTFields concomitant with CCNU was additive in MGMT-expressing
cell lines and showed potential of synergism in cell lines lacking MGMT
expression. Treatment eectiveness was further enhanced when TTFields
was applied concurrently with both TMZ and CCNU. TTFields were
shown to decrease the expression of proteins in the FA-BRCA pathway,
which is involved in the repair of CCNU (but not TMZ) induced DNA
damage in the absence of MGMT.
Discussion: Regardless of cellular MGMT expression levels, TTFields
therapy concomitant with TMZ and/or CCNU increased treatment e-
cacy. e BRCAness state induced by TTFields justies the synergy seen
for TTFields with CCNU, especially in cells lacking MGMT.
Conclusion: ese ndings suggest that TTFields therapy administered
concomitantly with TMZ/CCNU may have potential treatment benet for
GBM.
Disclosure Statement: e authors declare the following: All authors are employ-
ees and hold stock in Novocure.
722
Eectiveness and safety outcomes in patients with EBV+PTLD
treated with allogeneic EBV-specic T-cell immunotherapy
(tabelecleucel) under an expanded access program (EAP)
in Europe
Ralf Ulrich Trappe1; Sylvain Choquet2; Andrew Clark.43; Cécile Renard4;
Sridhar Chaganti5; Patrizia Comoli6; Xinyuan Duan7; Baodong Xing7;
Charley Wu7; Laurence Gamelin7; Jan-Henrik Terwey8; Anke Friedetzky8;
Daan Dierickx9
1DIAKO Ev. Diakoniekrankenhaus, Bremen, Deutschland
2Pitié-Salpêtrière Hospital, Paris, Frankreich
3NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
4Hospices Civils de Lyon, Lyon, Frankreich
5University Hospitals Birmingham NHS Trust, Birmingham, United Kingdom
6Fondazione IRCCS Policlinico San Matteo, Pavia, Italien
7Atara Biotherapeutics, Thousand Oaks, USA
8Atara Biotherapeutics Switzerland GmbH, Zug, Schweiz
9University Hospitals Leuven, Leuven, Belgien
Background: Pts with relapsed or refractory (r/r) EBV+ PTLD in Europe
have had historically poor ORR and median OS with no approved treat-
ment options. Tabelecleucel (Tab-cel), an o-the-shelf, allogeneic EBV-
specic T-cell immunotherapy has shown clinical benet and favorable
safety prole in the ttt of EBV+ PTLD failing rituximab ± chemotherapy.
Its recent European marketing authorization represents the 1st approval
of an allogenic T-cell immunotherapy.
Methods: Atara Bio supported expanded access requests for Tab-cel
in Europe. Here we report updated eectiveness and safety data for r/r
EBV+ PTLD pts who provided consent for research between Sep 2020
and Dec 2022.
Result: 74 EAP requests were received from 10 countries for pts with
r/r EBV+ diseases. 27 EBV+ PTLD pts consented to secondary use of
data and 24 pts had received ≥1 dose of Tab-cel, including 4 pts with
primary central nervous system (PCNS) PTLD. 16 of 24 (66.7%) PTLD
pts achieved a partial (PR) (33.3%) or complete response (CR) (33.3%),
with median time to response (TTR) of 1.0 mo (0.8–2.2). Response
rate for PCNS PTLD pts was 75% (1 CR, 2 PR). 1-yr OS Kaplan–Meier
(KM) estimate rates were 73.7% (95% CI: 47.3, 88.3) overall, 87.5%
in allogeneic HCT and 66.5% in solid organ transplant (SOT), with a
median follow-up time of 9.9 (2.4–13.9) and 6.0 (0.7–18.0) mo, respec-
tively. Serious ttt-emergent adverse events (TESAEs) were reported in 7
(29.2%) pts, including 1 fatal event of disease progression. Predened
risks for Tab-cel were reported in 3 pts; 1 (4.2%) SOT pt had a TESAE of
liver transplant rejection (grade 2) and 2 (8.3%) HCT pts had non-seri-
ous TEAEs of chronic gra-versus-host disease (grade 1 and 2). No cases
of cytokine release syndrome or tumor are reaction were reported. No
AEs were reported as related to Tab-cel by the treating physician.
Conclusion: ese updated real-world results for pts with r/r EBV+
PTLD post-HCT or post-SOT treated in the European EAP continue to
reinforce the favorable risk:benet prole of Tab-cel and are in line with
clinical study data supporting its recent EMA approval.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 149
864
Targeting lysosomal Acid Lipase activity as a novel
therapeutic approach for Pancreatic ductal adenocarcinoma
(PDAC)
Elisa Katharina Schürmann1,2; Dieter Niederacher1,2; Hans Neubauer1,2;
Nikolas H. Stoecklein2,3; Tanja Fehm1,2; Knud Esser1,2
1Klinik für Frauenheilkunde und Geburtshilfe, Düsseldorf, Deutschland
2Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
3Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Düsseldorf, Deutschland
Background: Lipid metabolic reprogramming contributes to the main-
tenance of cancer high stemness and is supposed to represent one major
characteristic of PDAC causing its extraordinary high malignancy.
erefore, targeting Lysosomal Acid Lipase (LIPA), signicantly overex-
pressed in PDAC, with Lalistat, a specic LIPA inhibitor, is analysed in
these studies to increase chemosensitivity to Paclitaxel and Folrinox and
to reduce metastasis in PDAC.
Methods: PANC-1 and MIA PaCa-2 cell lines were used as in vitro mod-
els. e cells were pre-incubated with Lalistat and DMSO (as a control)
at dierent concentrations for three days. Chemotherapeutics were then
added to the given Lalistat and DMSO concentrations for further three
days. Cell viability was analysed using the CellTiter Glo® assay.
Result: PANC-1 and MIA PaCa-2 cells exhibited a signicantly higher
chemosensitivity to Paclitaxel and Folrinox when incubated with Lalistat
compared to the cells incubated with DMSO.
Discussion: We have successfully demonstrated the impact of phar-
macological LIPA inhibition in generating a higher chemosensitivity to
Paclitaxel and Folrinox in cell culture models of PDAC. Further stud-
ies with Lalistat and Folrinox will be performed in the chorio-allantoic
membrane (CAM) model to investigate the in vivo eects with regard to
tumor proliferation and metastasis.
Conclusion: Our studies suggest that pharmacological inhibition of LIPA
has a high potential to improve current PDAC therapy and to oer new
targeted therapeutic options in the future.
Disclosure Statement: e authors declare no conict of interest.
871
In vitro live cell imaging for testing new anticancer therapies
to predict in vivo treatment ecacy
Dennis Kobelt; Maria Stecklum; Simone Rhein; Walther Wolfgang;
Jens Homann
EPO Berlin-Buch GmbH, Berlin, Deutschland
Background: e preclinical evaluation of novel cancer treatments like
immune cell based therapies and small molecule inhibitors demands com-
prehensive model systems in vitro that provide meaningful data before
entering in vivo studies. Here we evaluate the capabilities of live cell imag-
ing systems to evaluate novel immune cell therapies. Using immune cell
and small molecule based combinatorial approaches in vitro we demon-
strate, that these model systems can generate reliable data of pharmacody-
namic activity for further preclinical in vivo characterization.
Methods: Target cell killing was assessed in vitro with activated immune
cells. For combinatorial small molecule testing, conuent monolayers
were scratched. Cells were monitored every 2nd hour using the IncuCyte.
Dose-response-curves of single treatments and all combinations were
generated in parallel. For the in vivo validation, humanized mice were
generated by injection of CD34+ HSC or human immune cell subsets.
Immune cell engrament was monitored by FACS. To analyze the eect
of small molecule treatment, tumor cells were transplanted into spleens of
mice. Tumor development was monitored by BLI.
Result: Target cell killing by immune cells and monolayer wound healing
in 96 well format were successfully monitored in the IncuCyte. Here, data
can be generated over time without the need of new samples at every time
point compared with conventional end point measurements. ese data
predicted in vivo treatment outcome. Aer successful humanization of
mice, immune cells can be directed to kill tumor cells. Small molecule
combinations showing ecacy in vitro were most successful in vivo.
Discussion/Conclusion: e IncuCyte System provides in vitro data
that can directly translate into in vivo studies. We have shown activated
immune cells can kill target tumor cells in vitro. ese data have been
validated in in vivo experiments using immune cell humanized mice.
Further, small molecule based treatments can be tested either alone or in
combination allowing the preselection of active combinations for further
development.
Disclosure Statement: e authors declare the following: All authors are employ-
ees of EPO Berlin-Buch GmbH. JH is CEO of EPO Berlin-Buch GmbH.
884
Patients with colorectal and pancreatic cancer in the
Molecular Tumor Board of a Center for Personalized Medicine
Julia Didion1; Rika Jurkschat2; Lukas Perkhofer1; Stephan Stilgenbauer3;
Verena Ingeborg Gaidzik2,4; Thomas J. Ettrich1; Angelika Kestler1;
Thomas Seuerlein1,2
1Universitätsklinikum Ulm, Klinik für Innere Medizin I, Ulm, Deutschland
2Zentren für Personalisierte Medizin, Ulm, Deutschland
3Comprehensive Cancer Center Ulm (CCCU) am Universitätsklinikum Ulm, Ulm,
Deutschland
4Universitätsklinikum Ulm Klinik für Innere Medizin III - Hämatologie, Onkologie,
Rheumatologie, Infektionskrank., Ulm, Deutschland
Background: Personalized treatment strategies based on NGS sequencing
gain increasing importance in the treatment of patients with advanced
solid tumors. Results of tumor sequencing by large NGS panels or RNA
sequencing of patients with advanced tumors and no further established
treatment options are discussed in the molecular tumor board (MTB). In
case a druggable target that is likely to constitute a tumor driver is found,
o label used of targeted agents is supported by public health insurance.
Here we report the journey of patients with advanced pancreatic (PDAC)
and colorectal cancer (CRC) in the MTB at Ulm University hospital.
Methods: All patients with advanced PDAC and CRC discussed in the
MTB of the ZPM Ulm from 1/2020 until 6/2023 and who gave consent
were evaluated.
Result: 72 patients with advanced CRC (n=40) or PDAC (n=32) were
discussed in the MTP Ulm. In 47 patients no treatment could be recom-
mended. 25 patients received a treatment recommendation. 11 patients
died before initiation of therapy. 5 patients were lost to follow up. 1 patient
received another treatment. In 2 cases the application to the health insur-
ance company is still pending. 6 patients received the recommended
treatment (CRC: Trametinib, olaparib, trastuzumab-deruxtecan PDAC:
Palbociblib, pemigatinib, selumetinib). ere was one partial remission,
2 patients with stable disease and 3 patients with progressive disease as
best response.
Discussion: In this case series 8% of patients did receive a targeted treat-
ment aer recommendation by the MTB of which 50% benetted from
the treatment. is gure is below that reported from other MTB case
series. However, it has to be considered that only 2 rather dicult to treat
entities, advanced CRC and PDAC were included in the analysis.
Conclusion: NGS-based tumor analysis can achieve a benet for patients
with advanced, dicult-to-treat cancers. In future other means of analysis
but only gene sequencing shall be implemented to further improve target
identication in these tumors.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts150
911
Persistent Genetic Modication of Human Hematopoietic
Stem and Progenitor Cells Using S/MAR DNA Nanovectors
Patrick Derigs1,2; Alicia Roig-Merino3; Julia Peterson2; Luisa Burger2;
Sandra Sauer1; Tim Sauer1; Carsten Müller-Tidow1; Michael Schmitt1;
Richard Harbottle2
1Department of Internal Medicine V (Hematology, Oncology and
Rheumatology), University Hospital Heidelberg, Heidelberg, Deutschland
2DNA Vector Lab, German Cancer Research Center, Heidelberg, Deutschland
3MaxCyte, Inc., Gaithersburg, USA
Background: Transplantation of hematopoietic stem and progenitor
cells (HSPCs) electroporated with drug resistance inducing genes would
ensure eective tumor suppression by applying respective anticancer
therapy while maintaining sucient hematopoiesis in cancer patients.
Eective strategies for the persistent genetic modication of HSPCs are
needed for this treatment approach. Recombinant integrating viruses are
a potent and widely used tool. However, their random integration into the
genome introduces a risk of insertional mutagenesis. eir innate immu-
nogenicity presents another impediment to clinical application.
Methods: To achieve the goal of an ecient and safe generation of stably
transfected cells of a variety of cell types, we have developed a non-vi-
ral DNA vector platform based on Scaold/Matrix-Associated Regions
(S/MAR). e episomal maintenance of S/MAR DNA nanovectors (nS/
MAR) eradicates the risk of insertional mutagenesis, providing a major
advantage compared to already clinically applied approaches using
CRISPR/Cas9 systems or viral vectors. Additionally, with its unlimited
capacity, even large therapeutic transgenes or other sophisticated genetic
elements can be delivered with nS/MAR. In this study, we have evalu-
ated the eciency and persistence of reporter transgene expression in
the hematopoietic cell line K562 and primary human HSPCs using nS/
MAR. For electroporation the MaxCyte ExPERT® platform was used.
Transfection eciency and cell viability were analyzed by ow cytometry.
Results: Our study demonstrates the feasibility of using nS/MAR for
persistent genetic modication of K562 and HSPCs. Initial transfection
eciencies of primary human HSPCs of three dierent donors were high
with up to 82% positive cells. Transfected HSPCs retained reporter trans-
gene expression for 21 days in culture.
Conclusion: ese ndings provide a promising rst step towards the
persistent genetic modication of HSPCs with nS/MAR and their usage
in hematopoietic cell transplantation for the treatment of cancer patients.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
Oncological Pharmacy
427
Interferon-lambda (IFNL) germline variants and
responsiveness to chemo- and radiotherapy in cancer patients
Mia Mala Hafemann; Sabine Mihm
Universitätsmedizin Göttingen, Klinik für Gastroenterologie, gastrointestinale
Onkologie & Endokrinologie, Göttingen, Deutschland
Background: Chemo- and radiotherapy are known to trigger immune
activation via type I interferon (IFN) induction1. Time-event analyses of
ductal pancreatic adenocarcinoma (PAAD) and hepatocellular carcinoma
(HCC) patients revealed an association between IFNL gene variants and
PAAD disease progression, while this did not apply to HCC2. As PAAD
patients undergo chemotherapy at higher rates than HCC patients do, we
hypothesized that IFNL polymorphisms predispose for PAAD disease
progression via modulating therapy responsiveness.
Methods: IFNL genotypes (IFNL4 rs368234815 (TT/G) and surro-
gates) were read out from TCGA (e Cancer Genome Atlas) projects
with sucient chemo- or radiotherapy response data (i.e., BLCA, BRCA,
LUAD, PAAD, SARC, SKCM). Genotypes were analyzed for associations
with relevant clinical data.
Result: Genotype distributions in the respective cancer patient samples
reected those provided by the 1000 Genomes Project, except for mel-
anoma. Clinical data revealed virtually no association with IFNL geno-
types. A more in-depth analysis considering the P70S variant aecting
IFN-λ4 function and a stratication with regard to anthracyclines also
revealed no relation to therapy outcome.
Discussion: e deviation in allele distribution from the 1000 Genomes
Project reference sample in melanoma might point towards an allele-
driven tumor risk modulation. As analyses argue against the assumption
that the association between IFNL genotypes and PAAD disease pro-
gression is attributable to therapy response, further options are going
to be tested.
Conclusion: e association between IFNL variants and PAAD disease
progression appears not to be due to therapy responsiveness.
Indication of source:
1. Sistigu A, et al. (2014): Cancer cell-autonomous contribution of type I
interferon signaling to the ecacy of chemotherapy. Nat Med 20, 1301.
2. Huschka H, Mihm S (2020): IFNL germline variations and their signicance for
HCC and PDAC progression: an analysis of TCGA data. BMC Cancer 20, 1131.
Disclosure Statement: e authors declare no conict of interest.
435
Standardized patient information leaets for oral
anticancerdrugs
Jelena Rosentreter1; Clément Carbasse2; Klaus Meier1
1ESOP Global (European Society of Oncology Pharmacy), Hamburg,
Deutschland
2Service UPO – CHU de Nîmes, Nîmes, Frankreich
Background: e European Society of Oncology Pharmacy (ESOP
Global) has multiple “special interest groups” (SIG). e SIG “oral anti-
cancer drugs” (OAD) has, among others, the objective to improve health
literacy in oncology patients. Written patient information leaets (PIL)
about OAD are important for patient education. Until now, there are no
multi-national standards for PIL about OAD.
Methods: Aer six online meetings over the course of one year, the SIG
organized a live workshop in July 2023. e goal was to agree on a stan-
dardized template (ST) for PIL about OAD. e available national PIL
were used as sources.
Result: Out of the 13 countries represented in the SIG, eleven members
from eight countries participated in the workshop. e national PIL dier
greatly from one another. For the ST, a brief format (max. two pages) and
12 categories in patient friendly language were agreed on. ese catego-
ries are: international nonproprietary name (INN) of the OAD (optional:
brand name), photo of the OAD (optional), “Why are you taking this
medication?”, “How to take your medication, “What should you do if
you forget your medication or if you vomit?”, handling and storage, spe-
cic precautions, interactions, “e most common side eects that you
can recognize yourself, “When should you contact a healthcare profes-
sional?”, local contact and emergency number, disclaimer.
Discussion: Creating a ST for PIL about OAD is a rst step towards
improving health literacy in oncology patients. Using the ST for selected
OAD as an example, the SIG needs to reassess suitability and comprehen-
sibility of the PIL, users’ acceptance as well as organizational matters, e.g.,
translation and distribution via ESOP Global.
Conclusion: Pooling multi-national knowledge has led to a new and
unique ST for PIL about OAD. e SIGs joint work will need to continue
to pursue its goal of improving patient education. e aim is to make the
ST broadly available to ensure easy and global access and usage.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 151
751
Multi-professional database to improve adherence to oral
anticancer drugs
Klaus Meier1,2; Franziska Ockert-Schön2; Jelena Rosentreter2; Pauline Dürr2
1IFAHS, Hamburg, Deutschland
2DGOP, Hamburg, Deutschland
Background: Since 20 years research conrms that adherence to oral
medications is not guaranteed.(1) is can lead to signicant side eects
or loss of therapy, especially with oral cancer medicines with a narrow
therapeutic range. is calls for increased counselling(2) to improve
adherence.
Methods:. In most countries of the world, appropriate counselling in clin-
ics specialised in cancer treatment is mainly carried out by pharmacists
with positive results.(3) Since in Germany, oncology practices in private
practice prescribe these drugs and only public pharmacies are allowed
to dispense oral drugs in regular care, this increases the demands on the
individual professions and their professional skills.(4)
Result: To promote inter-professional communication and improve
adherence, the DGOP created a database 10 years ago in which both the
crucial information about the mode of action and the side eects and
interactions are available online and individualised intake sheets and doc-
umentation options can be created for the patient. Currently, 133 mon-
ographs and 25 co- medicines or medicines that are taken “as needed”
(PNR medicines) can be retrieved. 503 pharmacies use the database. 819
intake planes were prepared for advising patients in the last year alone.
Discussion: e evaluation of the intake forms will provide company-in-
dependent anonymous user data to assess the additional counselling
potential and PRO patient-related outcome.
Conclusion: Continuous counseling supported by a database provides
sustainable progress in treatment safety.
References:
(1) O’Neill VJ, Twelves CJ. British Journal of Cancer 2002; 87: 933–937.
(2) Osterberg L, Blaschke T. New Engl Journal Med 2005; 353: 487–497.
(3) Dennis M, Czarniak P. Journal of Cancer Education 2022; https://doi.org/
10.1007/s13187-022-02196-2.
(4) Meier K, Forum 2020; 35: 55–58 https://doi.org/10.1007/s12312-019-00742-6.
Disclosure Statement: e authors declare no conict of interest.
Onkologische Pege
4
Stellenwert eines Onkologischen Care-Teams auf
Lebensqualität, Autonomie und Therapietreue von
Krebspatienten in allen Phasen der Erkrankung
Beate Haensel1; Swen Wessendorf1; Janina Schrickel1; Thomas Okech2
1Cancer Center Esslingen, Esslingen, Deutschland
2Siloah Krankenhaus, Pforzheim, Deutschland
Background: Im Cancer Center Esslingen am Klinikum Esslingen
haben PatientInnen ab der Krebsdiagnosestellung die Möglichkeit
auf eine individuelle kontinuierliche Beratung, Begleitung und
Netzwerkarbeit. Innerklinisch, wie auch ambulant, telefonisch oder vor
Ort werden die PatientInnen in wesentlichen Fragen betreut und zum
Selbstmanagement angeleitet. Dies beinhaltet auch das Vorhandenseins
eines 24h Ruereitschasdienstes. Ziel der Studie ist es, den Eekt
der sektorenübergreifenden Begleitung und Beratung onkologischer
PatientInnen im Siloah Krankenhaus in Pforzheim zu vergleichen, denen
ein solches Versorgungsnetzwerk nicht zur Verfügung steht.
Methods: Mittels einer systematischen, prospektiven Befragung wurde
der Eekt einer sektorenübergreifenden Beratung und Begleitung
von krebserkrankten PatientInnen untersucht. Anhand eines
Fragebogens wurden über visuelle Analogskalen (VAS) entsprechende
Vergleichsparameter erhoben. Das PatientInnenkollektiv umfasste
PatientInnen mit einer Krebserkrankung (Erstdiagnose nicht länger als 6
Monate zurückliegend). Im Rahmen einer bizentrischen Fallkontrollstudie
wurden zu insgesamt drei Zeitpunkten Datensätze zu den Qualitäten
erapietreue, Lebensqualität und Patientenautonomie erhoben. Die
PatientInnen in Esslingen erhielten zusätzlich das Begleitungs- und
Betreuungsangebot durch STELLA Care.
Result: Insgesamt wurden 59 PatientInnen in die Studie aufgenommen.
Eine deskriptive Betrachtung der statischen Ergebnisse zeigte zum ema
Patientenautonomie einen quantitativen Unterschied. Keine Unterschiede
zeigten sich bei den Punkten erapietreue und Lebensqualität.
Conclusion: Die Wirksamkeit des Angebots von STELLA Care zeigte
sich vor allem in Bezug auf die PatientInnenautonomie. PatientInnen mit
zusätzlicher Beratung fühlten sich im Verlauf der Erkrankung weniger
überfordert. Das persönliche Sicherheitsgefühl insbesondere durch die
24stündige Erreichbarkeit war stärker ausgeprägt.
Disclosure Statement: e authors declare no conict of interest.
12
Integrative Nursing Interventions for Oncology Inpatients:
Results of the IMPLEMENT-UKU Project
Lea Raiber1,2; Johanna Thiele1; Klaus Kramer1
1Universitätsklinikum Ulm, Klinik für Allgemein- und Viszeralchirurgie,
Fachbereich Integrative Medizin, Ulm, Deutschland
2Interprofessionelles Graduiertenkolleg Integrative Medizin und
Gesundheitswissenschaften (IGIM), Witten, Deutschland
Background: Integrative nursing (IN) is an essential component of inte-
grative oncology. IN is dened by external, naturopathic nursing interven-
tions such as compresses, embrocation and foot/hand baths. In the project
“Implementation of IN at the University Hospital Ulm” (IMPLEMENT-
UKU), IN was initially carried out by an integratively trained nurse as a
consultation service on two oncology wards.
Methods: To ensure feasibility and acceptance of the project implemen-
tation, ongoing documentation of integrative nursing interventions (INI)
was established. Gender, age, and symptoms of the patients are docu-
mented, as well as the type of the INI, body region, oil used and duration.
Result: During the rst 12 months of the project, the consultation ser-
vice was requested by medical/nursing sta for 120 patients, of whom 110
accepted the oer of IN (91.7%). e mean age was 56.5 years, ranging
from 22 to 85 years. 59.1% were female. e most common symptoms
were restlessness and tension (37.3%), respiratory problems (33.7%),
and edema (34.9%). A total of 629 INI were performed. On average, the
patients received 5.7 INI (min=1, max=28) during their hospital stay. e
mean duration was 22 minutes (min=10, max=60). e most commonly
used INI were embrocation (84.7%) and compresses (10.0%). e most
treated body region was feet/legs (55.1%), followed by the back (25.8%)
and abdomen (8.6%). As a substance, lavender oil (28.5%) and solum oil
(24.8%) were the most frequently used.
Discussion: Acceptance of IN was high among all patients. It appears that
low-threshold INI such as embrocation and body regions such as the feet
were the main focus. e project and the further implementation of the
IN will be evaluated in an accompanying scientic research.
Conclusion: IN is an opportunity to support patients with non-pharma-
cological interventions during hospitalization. However, more in-depth
studies are needed in the future to evaluate the eects of INI in a focused
manner, as well as the eectiveness in a multimodal approach.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts152
89
Das Kompetenzteam onkologische Pege und Beratung - die
erfolgreiche Umsetzung der Zertizierungskriterien der DKG
in die Praxis
Silvia Krimm; Brigitte Kroh
Marienhaus Klinikum Mainz, Mainz, Deutschland
Background: Zur Gewährleistung einer umfassend fachpegerischen
Betreuung und Beratung aller Patient*innen mit onkologischen
Krankheitsbildern, gemäß den Anforderungskriterien zur Zertizierung
Onkologischer Organzentren der Deutschen Krebsgesellscha, wurde im
Marienhaus Klinikum Mainz im Jahr 2011 das Kompetenzteam onkolo-
gische Pege und Beratung (KOPB) gegründet.
Methods: Das KOPB ist integraler Bestandteil der pegerischen
Versorgung mit einem spezialisierten Angebot, welches sich am Leitbild
der Marienhausgruppe und den daraus abgeleiteten pegerischen
Vorgaben, sowie den Zertizierungskriterien der Organzentren der
Deutschen Krebsgesellscha orientiert.
Result: Aktuell besteht das Kompetenzteam onkologische Pege und
Beratung, kurz KOPB, aus sieben, nach DKG-Richtlinien weitergebildeten
Fachkrankenschwestern für Onkologie. Die eigenständige Organisation,
losgelöst vom regulären Stationsbetrieb der bettenführenden Abteilungen,
ermöglicht die volle Konzentration auf ihre Kernaufgaben. Die multipro-
fessionelle Zusammenarbeit, auch mit den supportiven Diensten innerh-
alb des Klinikums, ist, neben der individuellen Patientenbetreuung, ein
großer Bestandteil der täglichen Arbeit.
Discussion: In der Präsentation wird dargestellt, wie das KOPB organis-
iert ist, und welche Rahmenbedingungen für die tägliche Arbeit notwen-
dig sind. Es werden die Kernaufgaben des KOPB präsentiert, ebenso die
Vorteile die diese Organisationsstruktur für die einzelnen Zentren und
die Patientenbetreuung bietet. Zudem wird der Arbeitsalltag der onk. FPK
im KOPB am Beispiel des Viszeralonkologischen Zentrums dargestellt.
Conclusion: Diese Präsentation soll einen Einblick in die Tätigkeit
der onkologischen Fachpegekra geben und Anregung für andere
Einrichtungen sein, ähnliche Strukturen aufzubauen. Es wird gezeigt,
wie die Umsetzung der Zertizierungskriterien der Deutschen
Krebsgesellscha in der Praxis gelingen und auch gelebt werden kann.
Disclosure Statement: e authors declare no conict of interest.
256
Komplementäre Äußere Anwendungen bei onkologisch
Patienten mit sekundärem Lymphödem
Elke Kaschdailewitsch1; Birgit Kröger1; Bettina Noack1; Lioba Lohmüller1;
Andreas Schmitt1; Jan Valentini1; Stefanie Joos1; Regina Stolz1;
Cornelia Mahler2
1Institut für Allgemeinmedizin und Interprofessionelle Versorgung, Tübingen,
Deutschland
2Institut für Gesundheitswissenschaften Abteilung Pegewissenschaft,
Tübingen, Deutschland
Background: Onkologische Erkrankungen und ihre Behandlungen sind
die häugste Ursache für sekundäre Lymphödeme (sL). Die konventionel-
len therapeutischen Möglichkeiten sind begrenzt, insbesondere in pallia-
tiven Situationen oder wenn die Kompressionstherapie die Lebensqualität
einschränkt.
Die CCC-Integrativ Studie hat das Ziel, onkologisch Erkrankte interpro-
fessionell und evidenzbasiert zu komplementärer Medizin und Pege
(KMP) zu beraten, darunter auch zu sL. Äußere Anwendungen (ÄA) und
Akupressur (AP), als Maßnahmen, die auch für die Selbstfürsorge gee-
ignet sind, werden häug von Pegefachpersonen angewandt. Ziel war
es, komplementäre pegerische Maßnahmen bei sL zu identizieren und
hierzu zu beraten.
Methods: Ein 2-stuges Delphi-Verfahren auf Basis einer
Literaturrecherche mit n=8 PegeexpertInnen und n=4 ÄrztInnen,
mit Expertise in komplementären, naturheilkundlichen Verfahren
wurde durchgeführt. Bewertungskriterien zur Aufnahme in den KMP
Maßnahmen-Katalog waren: Wirksamkeit, Sicherheit, leicht anzuwenden
für PatientInnen und/oder Angehörige, kostengünstig.
Result: Es wurden 5 KMP Maßnahmen identiziert. In CCC-Integrativ
wurden von den n=603 Ratsuchenden n=64 (11%) zu sL beraten. Sie
wurden angeleitet zu: Einreibung mit ätherischen Ölen (n=24), Borago
Essenzwickel (n=19), Akupressur (Magen 40) (n=11), Quarkauage
(n=9), Kohlblattauage (n=3). Schriliche Anleitungen, mit detailliierten
Angaben zur sicheren Umsetzung Zuhause, wurden mitgegeben.
Discussion: Der KMP Maßnahmen-Katalog bot den Beratungsteams eine
Auswahl von KMP Maßnahmen mit höchstmöglicher Evidenz, zu denen
die Ratsuchenden individuell und gezielt beraten wurden. Am häugsten
wurde zu den sehr einfach anzuwendenden Maßnahmen (Einreibungen
und Essenzwickel) beraten.
Conclusion: Komplementäre ÄA könnten sinnvolle therapeutische
Maßnahmen zur Förderung der Selbstfürsorge und Steigerung der
Patientenaktivierung bei sL sein. Onkologisch Erkrankten sollten diese
erapieoptionen angeboten werden.
Disclosure Statement: e authors declare no conict of interest.
347
Komplementäre Äußere Anwendungen bei Hitzewallungen
durch antitumorale, endokrine Therapie
Bettina Noack1; Birgit Kröger1; Elke Kaschdailewitsch1; Andreas Schmitt2;
Lioba Lohmüller1; Jan Valentini1; Stefanie Joos1; Regina Stolz1;
Cornelia Mahler2
1Universiätsklinikum, Institut für Allgemeinmedizin und Interprofessionelle
Versorgung, Tübingen, Deutschland
2Universitätsklinikum, Institut für Gesundheitswissenschaften/
Pegewissenschaften, Tübingen, Deutschland
Background: Onkologisch Erkrankte mit antitumoraler, endokriner
erapie leiden häug unter Hitzewallungen (HW), welche die
Lebensqualität der Betroenen stark einschränken. erapeutische
Optionen sind begrenzt. Laut S3-LL Komplementärmedizin in der
Behandlung von onkologischen PatientInnen (S3 LL KM) „können
Akupunktur, Cimicifuga racemosa, Mindfulness Based Stress Reduction
und Yoga bei menopausalen Symptomen eingesetzt werden. Die CCC-
Integrativ Studie hatte das Ziel, onkologisch Erkrankte interprofes-
sionell und Evidenz basiert zu komplementärer Medizin und Pege
(KMP) zu beraten, darunter auch zu HW. Äußere Anwendungen (ÄA),
als Maßnahmen, die auch zur Selbstfürsorge geeignet sind, werden häu-
g von Pegefachpersonen angewandt. Ziel war es, komplementären
pegerischen Maßnahmen bei HW zu identizieren und zu beraten.
Methods: Ein 2-stuges Delphi-Verfahren auf der Basis einer
Literaturrecherche mit n=8 PegeexpertInnen und n=4 ÄrztInnen mit
Expertise in komplementären, naturheilkundlichen Verfahren wurde
durchgeführt. Bewertungskriterien zur Aufnahme in den KMP Katalog
waren: Wirksamkeit, Sicherheit, für PatientInnen und/oder Angehörige
leicht anzuwenden, kostengünstig. Die interprofessionellen Beratungen
wurden nach Beratungsanlass ausgewertet.
Result: Von den n=603 Ratsuchenden in CCC-Integrativ wurden
n=75 (12%) zu HW beraten. Ergänzend zur S3 LL KM wurden 5
weitere KMP Maßnahmen empfohlen: Salbei Tee innerlich (n=52), als
Waschung (n=36), Fußbad (n=17), Basenbad Teil- und Vollbad (n=16)
und Akupressur (Leber 3/Perikard 6) (n=51). Schriliche Anleitungen
mit detaillierten Angaben zur sicheren Umsetzung zuhause wurden
mitgegeben.
Discussion: Der KMP Katalog bot den Beratungsteams eine Auswahl
von KMP Maßnahmen mit höchstmöglicher Evidenz, zu denen die
Ratsuchenden individuell, aktivierend und gezielt beraten wurden.
Conclusion: Komplementäre ÄA könnten sinnvolle therapeutische
Maßnahmen zur Förderung der Selbstfürsorge und Steigerung der
Patientenaktivierung bei HW sein.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 153
399
Management of CAR T-cell therapy in pediatrics - nursing
recommendations for inpatient care
Julia Mattarei
Charité Universitätsmedizin, Berlin, Deutschland
Background: Chimeric antigen receptor T-cell therapy (CAR T-cell ther-
apy) is a potentially curative immunotherapy for pediatric patients with
relapsed or refractory B-ALL. However, life-threatening adverse events
may occur. Accurate nursing assessment leads to early recognition of
adverse events and may prevent the occurrence of complications. e aim
of this literature review is to provide evidence-based recommendations in
the management of CAR T-cell therapy for nurses. e research question
is: How can CAR T-cell therapy at a pediatric stem cell transplant ward be
designed in an evidence-based manner from a nursing perspective?
Methods: A literature search of 12 databases was conducted. e results
were considered with the inclusion of the nursing process.
Result: Six publications were included. Seven nursing recommendations
for the treatment of pediatric patients were derived from the results.
e focus is on education, database assessment, Lymphodepleting con-
ditioning, CAR T-cell infusion, side eect management and discharge
management.
Discussion: e included publications are largely based on experiences of
CAR T-cell centers and consensus opinions. In the absence of randomized
data, no strengths of evidence were assigned to the recommendations. e
importance of assessments was elaborated by linking them to the nurs-
ing process. Little evidence was found on counseling, illness experience
andcoping.
Conclusion: ere is a high degree of consensus in the selected literature on
the recommendations derived. eir application contributes to safe patient
care. ere is a need for research on nursing problems and their treatment
in the daily care of pediatric patients receiving CAR T-cell therapy.
Disclosure Statement: e authors declare no conict of interest.
469
Die Identikation pegerischer Beratungs- und
Unterstützungsbedarfe durch ein elektronisches,
multiprofessionelles Screening
Timo Gottlieb; Sarah Kühnel
Universitätsmedizin Essen, Essen, Deutschland
Background: Am Universitätsklinikum Essen ndet eine elektronische
Bedarfserhebung zu psychoonkologischen, palliativmedizinischen und
pegerischen Bedarfen statt. Die Befragung der Patient*innen ndet
sowohl im ambulanten, als auch im stationären Setting statt. Dieses Tool
wird bei allen onkologischen Patient*innen zur möglichen Anpassung der
Versorgungsstruktur genutzt. Das Tool wird EPOS genannt.
Methods: Ab Oktober 2022 werden die durchgeführten Screenings nach
einem vorgegebenen Algorithmus ausgewertet und ergeben ein Scoring.
Dieses Scoring wird täglich von einer multiprofessionellen Gruppe der
beteiligten Berufsgruppen ausgewertet. Daraus werden notwendige
Versorgungsalgorithmen abgeleitet und Maßnahmen eingeleitet.
Result: Im Rahmen der strukturierten Erfassung und Auswertung der
Ergebnisse seit Oktober 2022 wurden ca. 7.000 Screenings durchgeführt.
Auf dieser Basis konnten bereits zahlreiche Versorgungsstrukturen
angepasst werden. Dabei können auch bestimmte Regelmäßigkeiten im
Screening einzelnen Fachabteilungen des Universitätsklinikums zugeord-
net werden. Für die onkologische Fachpege können hier spezische
Beratungsbedarfe identiziert und Häufungen von Nebenwirkungen
einer Tumortherapie ausgewertet werden. Beispielha seien hier
Mangelernährung und Polyneuropathie genannt.
Discussion: Neben den bisher vor allem positiven Auswirkungen der
Anwendung des Screenings muss noch evaluiert werden, ob das Screening
in der aktuellen Form ausreichend ist, um alle Patient*innen zu identi-
zieren. Zudem muss noch strukturierter evaluiert werden, inwieweit das
Screening zielgerichtet eingesetzt werden kann.
Conclusion: Das EPOS-Screening bietet die Möglichkeit, den Bedarf für ver-
schiedene Berufsgruppen zu identizieren. Erste Ergebnisse konnten insbe-
sondere in den Bereichen KMT, Gynäkologie und soliden Onkologie einen
erhöhten Bedarf messen. Es wird weiter daran gearbeitet, das Screening
strukturiert auszuwerten und weitere wissenschaliche Daten zu erheben.
Disclosure Statement: e authors declare no conict of interest.
510
Erleben und Gestalten des Behandlungsprozesses der
allogenen Stammzelltransplantation aus der Sicht von
Pegefachpersonen
Sarah Kühnel
Universität Witten/Herdecke, Department für Pegewissenschaft, Fakultät für
Gesundheit, Witten, Deutschland
Background: Die pegerischen Versorgungsschwerpunkte in der
erapie der allogenen Stammzelltransplantation sind vielfältig und
komplex. Die Perspektive der Pegenden, die in diesem besonderen
erapiefeld der Hämatologie tägig sind, wurde in wissenschalichen
Arbeiten kaum fokussiert. Das Ziel der Arbeit ist die Erfassung und
Darstellung des Erlebens und Gestaltens des Behandlungsprozesses bei
allogener Stammzelltransplantation aus Sicht von Pegenden.
Methods: Zur Beantwortung der Fragestellung wird ein qualitatives Design
genutzt. Es werden semistrukturierte, leitfadengestützte Interviews mit
Pegenden, die in der erapie der allogenen Stammzelltransplantation
tätig sind, geführt. Die Auswertung erfolgt mittels der Grounded-eory
nach Strauss und Corbin.
Result: Erwartet werden Ergebnisse, die Hinweise auf die vielfältigen
Aufgabenschwerpunkte der in der Versorgung tätigen Pegefachpersonen
und ihrem persönlichen Erleben dieser Arbeiten geben. Erste Ergebnisse
zeigen, dass die pegerische Arbeit sich durch verschiedene Faktoren als
sehr intensiv darstellt.
Discussion: Die Pegenden nehmen eine essenzielle Rolle in der Begleitung
während der stationären Phase und der Vorbereitung ihrer Patient:innen
und Angehörigen, auf das Leben nach der Stammzelltransplantation
ein. Diese Erkenntnisse geben Hinweise auf die Vielfältigkeit der von
den Pegenden geforderten Kompetenzen, u.a. die Edukation und den
Beziehungsauau. Es zeigt sich, dass eine individuelle und ganzheitliche
Sicht auf die Patient:innen unerlässlich ist.
Conclusion: Bisher besteht wenig wissenschaliche Fokussierung auf die
pegerische Versorgung während der allogenen Stammzelltransplantation.
Erste Ergebnisse dieser Arbeit zeigen jedoch auf, wie intensiv die pegeri-
sche Begleitung der Patient:innen in der erapie ist. Diese Arbeit kann in
der Praxis dazu genutzt werden, ein besseres Verständnis für pegerisches
Handeln zu generieren.
Disclosure Statement: e authors declare no conict of interest.
626
Fatigue - an underestimated symptom in pediatric oncology
Tobias Hemicker
Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz,
Deutschland
Background: Whilst becoming a specialist nurse for pediatric oncology
you learn a lot about dierent symptoms, which can occur during and
aer treatment of pediatric cancer. Fatigue as one of them made me think-
ing: If there is fatigue amongst pediatric patients, how could you measure
it? What do my follow nurses know about fatigue. Which possible ways of
supporting treatment do they know and use?
Methods: A literature research was undertaken aiming for the percep-
tion of the topic “fatigue amongst pediatric cancer”. In addition, a survey
under fellow pediatric nurses working in pediatric oncology was carried
out asking for their knowledge and actions concerning fatigue. As last
component, a comparison between dierent assessment tools has been
accomplished.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts154
Result: All by the research found data showed that there could be found
fatigue amongst pediatric patients. What all found literature also showed
was that there is not jet much research done concerning fatigue in pediat-
ric oncology. e survey showed that all fellow nurses knew about fatigue
and possible ways to treat it. e search for an assessment, which is suita-
ble for pediatric patients from age 0 to 18, revealed three. In comparison,
they are more or less suitable in their construction for each age group.
Discussion: Commonly fatigue is listed as one of the most common
symptoms in patients with cancer. Surprisingly there could not be found a
prove on an implementation of an assessment in pediatric oncology.
Conclusion: ere is fatigue in pediatric patients, which are undergoing
or have undergone cancer treatment. Sadly, fatigue is not really a topic
during the daily work.
Nurses know about fatigue and possible ways to act against its possible
consequences. Intuitively nurses act against fatigue and try to motivate
and agitate their patients.
Each of the three found assessments has its strengths and weaknesses. It
has to be distinguished whether you want to use an assessment which is
applicable for the whole age group, that can be found in pediatric oncol-
ogy or if you want to use an assessment which is more specic for an
specic age group.
Disclosure Statement: e authors declare no conict of interest.
713
Erhebung des psychoonkologischen Unterstützungsbedarfs
durch die onkologische Pege: Chance für
Kompetenzzuwachs oder lästige Bürokratie?
Johannes Bösche1; Daniela Breitschuh2
1Uniklinik Köln, Zentrale Onkologische Fachpege, Pegedirektion, Klinik 1 für
Innere Medizin, Köln, Deutschland
2Uniklinik Köln, Klinische Psychoonkologie, Klinik 1 für Innere Medizin, Köln,
Deutschland
Background: Die DKG-Zertizierungsvorgaben für die Psychoonkologie
sehen ein ächendeckendes Screening vor. An der Uniklinik Köln
übernimmt neuerdings die onkologische Pege die Durchführung des
psychoonkologischen Screenings (POS) im stationären Bereich und leitet
selbständig die psychoonkologische Versorgung in die Wege. Dadurch
werden deutlich mehr Patient:innen mit einem Unterstützungsbedarf
identiziert. Erleben die Pegenden diese neue Aufgabe als
Kompetenzerweiterung (1) oder als zusätzliche Arbeitsbelastung?
Methods: Zunächst wurden zwei Expert:innen Interviews mit Pegenden
geführt, die mit dem Distress-ermometer arbeiten. Hierzu wurde
ein teilstandardisierter Leitfaden genutzt, der mithilfe der Erkenntnisse
aus der Implementierungsphase entwickelt wurde. Weiterhin sind
Fokusgruppen und Einzelinterviews mit Pegenden verschiedener
Bereiche sowie pegerischen Leitungen geplant. Es folgt eine Auswertung
auf Basis der qualitativen Inhaltsanalyse nach Mayring.
Result: Erste Ergebnisse deuten darauf hin, dass Pegende die Übernahme
des Screenings begrüßen. Die Optimierung der Prozesse (weniger
Schnittstellen, schnellere Kontaktaufnahme, KIS) wird positiv bewertet. Die
Mehrarbeit wird als gering erachtet. Zudem erleichtert die Durchführung
des Screenings den Pegenden, sensible emen anzusprechen.
Discussion: Die Ergebnisse geben Hinweise, dass mit der Übernahme
des POS eine Komptenzerweiterung verbunden ist. Hierbei erscheint
die eigenständige Veranlassung der psychoonkologischen Betreuung auf
Basis des Assessments als entscheidender Faktor.
Conclusion: Die aktive Beteiligung der Pege führt zu einer Verbesserung
des POS. Pegende leisten somit einen wichtigen Beitrag zur psychoonkol-
ogischen Versorgung. Die neu gewonnene Handlungsfähigkeit und
daraus resultierende Wirksamkeit führt zu einem Kompetenzzuwachs,
der positiv erlebt wird.
Indication of source:
1 Olbrich, C. (1999): Pegekompetenz. Verlag Hans Huber: Bern.
Disclosure Statement: e authors declare no conict of interest.
780
Komplementäre Pege als Ergänzung der supportiven
Therapie in der Onkologie – eine Querschnittsstudie
Sandra Liebscher-Koch1; Judith Büntzel2; Maren Schürmann1
1Universitätsmedizin Göttingen, Göttingen, Deutschland
2Klinik für Hämatologie und Medizinische Onkologie, Göttingen, Deutschland
Hintergrund: Die komplementäre Pege (KP) ist seit Jahren fester
Bestandteil der Patient*innenversorgung an der Universitätsmedizin
Göttingen. Ein Team aus speziell ausgebildeten Pegefachpersonen
betreut im Rahmen eines Konsildienstes die Patient*innen (Pat) und
schult medizinisches Personal.
Methodik: Durchgeführte Konsile wurden über einen denierten
Zeitraum anonym erfasst. Daten zu Diagnose, erapieziel (kurativ/pal-
liativ), Pegeproblem, komplementäre Methode sowie komplementärer
Maßnahme und Zeitaufwand wurden dokumentiert.
Ergebnisse: Insgesamt wurden 99 Konsile erfasst. 23 der konsultierten Pat
waren männlich, 76 weiblich. Das mediane Alter betrug 61 Jahre (22-93
Jahre). Am häugsten erfolgte eine Beratung von Pat mit hämatologischen
Neoplasien (22/99 Pat) und gastroenterologischen (33/99 Pat) Tumoren.
Es wurden insgesamt 21 verschiedene Pegeprobleme dokumentiert.
Am häugsten wurden die Pegeprobleme Schmerz (20,4%, 30/99 Pat),
Unruhe/Angst (19.1%, 28/99 Pat), psychische Probleme/ depressive
Verstimmung (8,2%, 12/99 Pat), Lymphödem und Verdauungsprobleme
(je 7,8, 11/99 Pat) dokumentiert. Insgesamt wurden sieben Methoden
beschrieben (Aromapege, Auage/Wickel, Beratung, Einreibung,
Gespräch, Heiltee, rhythmische Einreibung). Insgesamt erhielten 99 Pat
146 Interventionen. Am häugsten wurden die Aromatherapie (50,7%,
74/146) und die rhythmische Einreibung (32,9%, 48/146 Pat) angewandt.
Diskussion: Die komplementäre Pege wird konsiliarisch vor allem bei
Schmerzen und psychischer bzw. seelischer Belastung angefordert. Als
Methoden sind die Aromatherapie und rhythmische Einreibung am
präsentesten. Der zeitliche Aufwand zur Schulung von Angehörigen oder
des direkt betreuenden Pegefachpersonal ist mit i. d. R. ca. 15 min gut in
den klinischen Alltag zu integrieren.
Schlussfolgerung: Komplementäre Pegeberatung im onkologischen Setting ist
praktikabel, gut durchführbar und eine sinnvolle Ergänzung zur onkologischen
Supportivtherapie.
Disclosure Statement: e authors declare no conict of interest.
819
”Was sieben Jahre währt, ist nie verkehrt“
Susanne Blöß1; Aneta Smuda2; Sandra Juhnke2; Mathias Lier2;
Lena Reckermann2; Christine Reichard2
1Medizinische Hochschule Hannover, KMT-Ambulanz OE 6863, Hannover,
Deutschland
2Medizinische Hochschule Hannover, Hannover, Deutschland
Background: 2016 wurde der Onkologisch Pegerische Konsiliardienst
(OPK) gegründet. Die onkologisch Fachpegenden des OPK bieten eine
Mitbetreuung während des stationären Aufenthaltes in der Medizinischen
Hochschule Hannover an. Zusätzlich werden in unterschiedlichen
Schwerpunktambulanzen ambulante Patient: innen versorgt. Sowohl
in den Ambulanzen, als auch auf den Stationen der MHH beraten die
Fachpegenden Patient:innen und deren Zugehörige zu therapiebed-
ingten Nebenwirkungen und Symptomen. Die Beratungsanfragen sind
in den letzten Jahren kontinuierlich gestiegen. Die Diagnose Krebs stellt
ein einschneidendes Lebensereignis dar. Dementsprechend ist es wichtig,
dass die Patient:innen das erapiegeschehen nachvollziehen und aktiv
mitgestalten können. Die Beratung erfolgt zum einen symptomorientiert,
umfasst aber auch den psychosozialen Kontext und die Lebenswelt der
Patient: innen.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 155
Methods: Die Daten der Patient:innenbefragung des OPK wurden von
Mai bis Dezember 2020 erhoben. Das Befragungsinstrument wurde in
gedruckter Form den Patient:innen ausgehändigt. Der Rücklauf erfolgte
über die Mitarbeiter:innen der Schwerpunktambulanzen.
Result: Neben Fragen zur Zufriedenheit, wurde auch das
Symptommanagement evaluiert und die Weiterleitung an unterstützende
Dienste erfragt. Die Freitextbereiche konnten für Verbesserungsbedarfe
und individuelle emen genutzt werden.
Discussion: Die Entwicklung des Onkologisch Pegerischen
Konsiliardienstes (OPK) in der Medizinischen Hochschule Hannover
(MHH).
Conclusion: Komplexe Gesundheitsstörungen sowie moderne onkol-
ogische Tumortherapien haben unterschiedliche erapieverläufe zur
Folge. Die steigende Anzahl der Beratungsanfragen zeigt den erhöhten
Pegeberatungsbedarf der Betroenen sowie der Zu- und Angehörigen.
In der Auswertung der Patient:innenbefragung wird deutlich, dass die
Betroenen das Pegeberatungsangebot außerordentlich positiv bewer-
ten und davon persönlich protieren.
Disclosure Statement: e authors declare no conict of interest.
930
Körper er lebens orientierte Pegeinterventionen in der
Begleitung von Frauen mit fortgeschrittenem Brustkrebs
in der letzten Lebensphase
Sara Marquard
Universität Osnabrück, Osnabrück, Deutschland
Background: Über die spezischen Bedürfnisse sowie psychosozialen
Belastungen von Frauen mit einer heilbaren Brustkrebserkrankung ist
viel bekannt. Dagegen ist nicht dierenziert und empirisch belastbar
untersucht, wie Frauen mit einer fortgeschrittenen Brustkrebserkrankung
in der letzten Lebensphase ihre körperlichen Beeinträchtigungen erleben
und wie spezialisierte Pegefachpersonen angemessen darauf reagieren
können.
Methods: Um die subjektiven Vorstellungen von körperlichen
Veränderungsprozessen und deren Auswirkungen auf das Alltags(er)
leben von unheilbar an Brustkrebs erkrankten Frauen zu erfassen, wurde
die Grounded-eory-Methodologie nach dem Vorgehen von Strauss
und Corbin gewählt. Insgesamt wurden 22 leitfadengestützte Interviews
mit Frauen in deren Häuslichkeit, im Hospiz sowie in akutstationärer
Versorgung geführt.
Result: Das zentrale Phänomen Gezeichnet sein zeigt sich bei allen Frauen
in einem veränderten Aussehen, spürbaren Veränderungen sowie einem
zunehmenden körperlichen Verfall. Ursache dafür sind insbesondere
die zum Teil Jahre andauernden palliativen erapien und damit ver-
bundene massive Nebenwirkungen sowie ein zunehmender Progress
der Erkrankung, was zusammengenommen unumkehrbar zu einer
Verschlechterung des körperlichen Bendens führt.
Discussion: Um die praktische Ebene der Körperarbeit erreichen zu kön-
nen sind pegerische Bildungsprozesse erforderlich. Pegefachpersonen
müssen in leiblicher Kommunikation sensibilisiert und geschult werden,
Wahrnehmungskompetenzen sollten stärker Berücksichtigung nden.
Conclusion: Dann kann dem Gezeichnet sein mit körpererle-
bensorientierten Pegeinterventionen begegnet werden. Vor dem
Hintergrund der Erfahrungen der interviewten Frauen lassen sich fol-
gende Pegehandlungen ableiten: Frauen in der Versprachlichung ihres
rpererlebens ermutigen, über die letzte Lebenszeit sprechen, körperor-
ientierte Routineangebote kritisch reketieren. Dies kann dazu beitragen,
das Körpererleben positiv zu beeinussen.
Disclosure Statement: e authors declare no conict of interest.
Other Topics
53
Advancing patient involvement in clinical research - The
Patient Advisory Board of the Study Center of the German
Society of Surgery
Magdalena Holze1,2; Sophia Vogel-Adigozalov2; Solveig Tenckho2;
Maximilian Joos1,2; Rosa Klotz1,2; Patient Advisory Board (Sdgc)2
1Universitätsklinikum Heidelberg, Klinik für Allgemein-, Viszeral- und
Transplantationschirurgie, Heidelberg, Deutschland
2Studienzentrum der Deutschen Gesellschaft für Chirurgie, Heidelberg,
Deutschland
Background: e perspective of patients has historically not been heard
in both clinical research and care. Currently, just few scientic institu-
tions provide sustainable mechanisms for patient involvement in research
projects. Nevertheless, patient involvement has gained importance and is
now advocated not solely by patient representatives and researchers, but
also demanded by funders. To meet these requirements and to strengthen
active patient involvement the Patient Advisory Board (PAB) of the
Study Center of the German Society of Surgery (SDGC) was founded at
Heidelberg University Hospital in 2021.
Methods: e PAB comprises 16 members including patients undergo-
ing major surgery, their relatives, and representatives of patient support
groups, such as ILCO, and AdP. e PAB has developed and adopted
its own bylaws and meets regularly. PAB activities include prioritizing
research topics, advising on grant applications, generating trial docu-
ments and publications in lay terms, and involvement in study design and
study-related committees.
Result: As of August 2023, the PAB has conducted a total of 17 meetings
and advised 20 study ideas from researchers nationwide for funding appli-
cations. 6 PAB representatives have been integrated into trial committees,
contributing actively to the conduct of these trials. Besides, 2 own BMBF-
funded projects were initiated in cooperation with the PAB: a systematic
review examining the current status of patient involvement in surgical
trials and a conceptional phase aimed at designing a multicenter RCT on
prehabilitation in colorectal cancer patients.
Discussion: Institutions like the PAB play a pivotal role in advancing patient
involvement, enabling researchers to actively incorporate patient experience.
Conclusion: e PAB is one of the rst patient advisory boards in
Germany. Its high level of activity and advocacy by patients, research-
ers and funders demonstrates the need for such institutions within the
German research landscape.
Disclosure Statement: e authors declare no conict of interest.
153
Establishment of a central registry as an option for improved
access to clinical trials at the Krukenberg Cancer Center Halle
(KKH)
Lara-Marie Schulze1; Hichem Ben Hamed2; Sandra Ehlert1; Federica Bini3;
Corinna Kistner2; Haifa Al-Ali1; Daniel Tiller2; Jan Christoph2,3;
Susann Schulze1
1Krukenberg Cancer Center Halle, University Medicine Halle, Halle (Saale),
Deutschland
2Data Integration Center, University Medicine Halle, Halle (Saale), Deutschland
3AG (Bio-)Medical Data Science, Martin-Luther-University Halle-Wittenberg,
Halle (Saale), Deutschland
Background: In oncology, it is important to provide patients with a
comprehensive oer of clinical trials. erapy options are becoming increas-
ingly specic, meaning that the inclusion criteria for clinical studies are
becoming more restrictive and the study designs more complex. In order to
provide appropriate trials to all patients, a complete overview of available trials
is needed for treating physicians. [1] We show that this can be implemented by
creating an electronic database at the Krukenberg Cancer Center Halle (KKH).
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts156
Methods: With the Research Electronic Data Capture (REDCap) a collec-
tion with meta data of all available clincical studies at the location is build.
Its data can be displayed by Reports within REDCap. More complex Queries
are shown in the collaboration platform Conuence using Structured
Query Language (SQL). Compliant with data protection requirements, the
data is stored on internal servers of the University Medicine Halle (Saale).
Results: e trial registry was built from April 2022 to May 2023. To enter
and store data consistently and centrally, study attributes were integrated
in forms. Analyses are presented as tables. Besides three REDCap reports
there are further 29 at Conuence. e data are available and daily updated.
Discussion: A user friendly electronic trial registry for the KKH was suc-
cessfully implemented. While providing an enhanced workow, the set up
of the database requires high eort. Computer science skills are necessary
to manage complex reporting structures. us, close cooperation of the
KKH and the Data Integration Center is essential.
Conclusion: Digitization in the healthcare sector, requires close collabo-
ration between a Data Integration Center and medical sta. In this way,
process optimization can be achieved. An extension of the project to
external partners would be desirable.
Indication of source:
1 Unger JM, et al. American Society of Clinical Oncology Educational Book36
(May 19, 2016) 185–198. DOI:10.1200/EDBK_156686.
Disclosure Statement: e authors declare no conict of interest.
207
Evaluation and implementation of multidisciplinary and
standardized long-term follow-up care for adult survivors of
childhood cancer in Germany – A prospective, multi-centric,
nationwide study (LE-Na)
Chirine Cytera1; Katja Baust2; Anja Borgmann-Staudt3;
Gabriele Calaminus2; Katharina Egger-Heidrich4; Jörg Faber5; Desiree
Grabow6; Teresa-Veronika Halbsguth7; Ann-Kristin Kock-Schoppenhauer8;
Inke König9; Sebastian Michaelis10; Anke Neumann8; Alexander Puzik11;
Sonja Schuster12; Marianne Sinn13; Thorsten Langer1; Judith Gebauer14
1Paediatric Haematology and Oncology, University Hospital of Schleswig-
Holstein, Campus Luebeck, Lübeck, Deutschland
2Department for Paediatric Haematology/Oncology, University Hospital Bonn,
Bonn, Deutschland
3Department of Paediatric Oncology and Haematology, Charité-
Universitätsmedizin Berlin Germany, Corporate Member of Freie Universität
Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin,
Deutschland
4Department of Internal Medicine I, University Hospital Carl Gustav Carus,
Dresden, Dresden, Deutschland
5Department of Pediatric Hematology, Oncology, and Hemostaseology,
Center for Pediatric and Adolescent Medicine, University Medical Center of the
Johannes Gutenberg-University Mainz, Mainz, Deutschland
6Division of Childhood Cancer Epidemiology / German Childhood Cancer
Registry, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI),
University Medical Centre of the Johannes Gutenberg University Mainz, Mainz,
Mainz, Deutschland
7Medical Clinic II, Haematology and Oncology, University Hospital Frankfurt am
Main, Frankfurt am Main, Deutschland
8IT Center for Clinical Research, University of Luebeck, Lübeck, Deutschland
9Institute of Medical Biometry and Statistics, University of Luebeck, University
Hospital of Schleswig-Holstein, Campus Luebeck, Lübeck, Deutschland
10Department of Paediatric Oncology and Haematology, University Hospital
Tübingen, Tübingen, Deutschland
11Division of Paediatric Haematology and Oncology, Department of Pediatrics
and Adolescent Medicine, Medical Center, Faculty of Medicine, University of
Freiburg, Freiburg, Deutschland
12Department of Paediatric Haematology and Oncology, University Hospital
Erlangen, Erlangen, Deutschland
13II. Department of Medicine, University Medical Center Hamburg-Eppendorf,
Hamburg, Deutschland
14Department of Internal Medicine I, University Hospital of Schleswig-Holstein,
Campus Luebeck, Lübeck, Deutschland
Background: Late eects can occur years to decades aer cancer ther-
apy, resulting in morbidity and reduced health-related quality of life
(HRQOL) in cancer survivors. Clinical long-term follow-up (LTFU) ena-
bles timely diagnosis and treatment of these sequelae. So far, only a minor-
ity of German childhood cancer survivors (CCS) regularly visit LTFU care
facilities.
erefore, this study aims to: 1. implement and/or improve LTFU care
structures for adult CCS in Germany, 2. inform former patients about late
eects and LTFU care centers, 3. prospectively assess the prevalence of
chronic health conditions in this cohort and document them in a com-
mon research database 4. establish a clinical long-term follow-up cohort
of adult CCS in Germany.
Methods: Within ve years, over 5000 CCS will be addressed and - follow-
ing their interest - recruited and treated in 10 LTFU centers in Germany.
Study participants are either invited by the German Childhood Cancer
Registry, transitioned from the local pediatric care unit, or contact the
study centers by themselves. Patients are assigned to one of three dierent
risk groups based on their cancer treatment exposure and receive stan-
dardized follow-up care.
Primary study endpoints are satisfaction with the LTFU care oer and
improvement of health-related self-ecacy and will be assessed at two
time points with an interval of three years. Furthermore, an evaluation of
the implemented LTFU care will be enabled by a wait list control group:
e intervention group receives LTFU care as soon as possible. ey com-
plete questionnaires before their rst visit and one year aer. e waiting
control group completes the questionnaires at the initial timepoint and
one year later. ey receive the same intervention aerwards.
All study ndings are documented in a standardized database.
Results and Conclusion: By oering standardized LTFU care to CCS in
Germany that have not received LTFU yet, the LE-Na study expects to
improve nationwide LTFU care and therewith patients satisfaction with
the LTFU care oer as well as their HRQOL.
Disclosure Statement: e authors declare no conict of interest.
208
Evaluating the eect of home parental nutrition in cancer
patients using the bioelectrical impedance analysis
Jan Simon1; Margaret Sommer2; Raika Mühlberg2; Rebecca Klindworth2;
Luzia Valentini1
1Hochschule Neubrandenburg, University of Applied Sciences,
Neubrandenburg, Deutschland
2Elb-Apotheke, Hamburg, Deutschland
Purpose: Few studies show the eect of home parenteral nutrition (HPN)
assessed by bioelectrical impedance analysis (BIA), a validated method for
analyzing body composition. e objective of this mixed-method study
was to evaluate body composition, with a special focus on the functional
parameter phase angle, in cancer patients over 2 months aer starting
supportive HPN.
Methods: Adult cancer patients receiving supportive HPN with or with-
out anticancer treatments in care of the Elb-Apotheke (Hamburg) were
included between July and September 2022. Patients were assessed at start
of HPN and aer 30 and 60 days. Assessment included body composi-
tion (BIA seca mBCA525, Nutriguard-MS), anthropometric and clinic-
oncological characteristics. Aer 60 days, semi-structured interviews
were conducted with 5 patients.
Results: Overall, 14 patients (71,4% men) were examined (60±16 years,
body mass index (BMI): 21.5±4.0 kg/m²). Cancer localization was mostly
gastrointestinal (64.3%). Phase angle did not change over time (4.8±1.1° vs.
5.0±0.9°, p=0.406), but body weight, BMI, fat-free mass index and skeletal
muscle mass improved signicantly (p<0.05). Interviewed patients showed
a better understanding of HPN through the presentation of BIA results.
Discussion: e results are line with two other studies with higher sample
sizes and longer observation time (1, 2). e insignicant eects on phase
angle might be due to anticancer treatment (2).
Conclusion: Two months of HPN resulted in improved body weight
and body composition but without signicant eect on phase angle.
Discussing the BIA results with patients can lead to a better understand-
ing of HPN and possibly better adherence.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 157
References:
1. Cotogni P, Monge T, Fadda M, De Francesco A. Bioelectrical impedance
analysis for monitoring cancer patients receiving chemotherapy and home
parenteral nutrition. BMC Cancer. 2018;18(1):990.
2. Pelzer U, Arnold D, Goevercin M, Stieler J, Doerken B, Riess H, et al.
Parenteral nutrition support for patients with pancreatic cancer. Results of a
phase II study. BMC Cancer. 2010;10(1):86.
Disclosure Statement: e authors declare no conict of interest.
211
Benets of the Introduction of a Monitoring Program and
Field Crew Service in Cancer Registration in Rhineland-
Palatinate
Petra Plachky; Hans Christian Lange; Diana Bergner; Sarah Franz;
Christina Justenhoven; Julia Gildemeister
Cancer Registry of Rhineland-Palatinate in the Institute for Digital Health Data
RLP gGmbH, Mainz, Deutschland
Background: Reporting of cancer diagnoses, treatment and follow-up to
clinical cancer registries is mandatory in Germany. e datasets of cancer
registries are used for quality assessment and improvement of oncological
care. ese investigations depend on data quality, which is restricted by
data ow to cancer registries. To solve this issue, the cancer registry in
Rhineland-Palatinate established a monitoring program and a eld ser-
vice. e monitoring program comprises systematic evaluation of onco-
logical facilities regarding number and quality of reports. Deviationists
are contacted personally to remind them of the reporting obligation and
to oer support by the eld service. e mission of this service is the sup-
port of medical facilities regarding reporting to the cancer registry or indi-
vidual training.
Methods: e success of both initiatives was measured by the number
of newly reporting facilities and the number of incoming reports in
correlation with these initiatives. In addition, the number of patients,
that were only notied due to these eorts, was calculated. Our anal-
yses were done by R and based on the dataset of the cancer registry of
Rhineland-Palatinate.
Result: Our initiatives showed considerable success with > 120 institu-
tions starting to report to the cancer registry, > 80,000 reports transmitted
by the eld service and > 7,000 patients, which were only notied due to
these special eorts.
Discussion: e monitoring program and the eld service impressively
improved the data quality of the cancer registry of Rhineland-Palatinate.
Beside the individual success of both initiatives, particularly, their inter-
action contributed to the observed quality intensication. We assume that
the personal contact including admonition (monitoring program) and
support (eld service) is the basis of this success.
Conclusion: e herein reported results demonstrate that monitoring
programs and a eld crew service are crucial for quality of data and subse-
quent analyses in cancer registries.
Disclosure Statement: e authors declare no conict of interest.
215
What burdens and resources do family members of cancer
patients have?
Melanie Jagla-Franke1,2; Merle Nathalie Schilling3; Gabriele Helga Franke2
1Hochschule Neubrandenburg, Neubrandenburg, Deutschland
2Hochschule Magdeburg-Stendal, Stendal, Deutschland
3Westküstenklinikum Heide, Heide, Deutschland
Background: Cancer aects not only the patients, but also their family
members [1]. In recent years has research interest focused not only on
patients but also on relatives. e study aimed to look at psychosocial
aspects of relatives.
Methods: 219 relatives of cancer patients (43.7 ±13.8 years, 52.1% female)
took part in the study. e Distress-ermometer [DT, 2] and the Mini-
SCL [3] were used to assess psychological distress, the Essen Coping
Questionnaire [4] was used as well as the Oslo Social Support Scale [5].
Result: Relatives of cancer patients showed higher values in the DT
(p<.0001, d=0.52) than the comparison sample [2]. ey also showed
mild distress in three out of four Mini-SCL-scales [3]. Compared to [5],
they described lower social support (p=.042, d=0.16). With regard to cop-
ing strategies, only comparative data from parents of children with cog-
nitive impairments (CI; n=118) are available. Relatives of cancer patients
described lower mean values for eight of the nine scales, with small to
large eect sizes.
Discussion: As described in the literature, cancer had an inuence on
the relatives in this sample as well. ey showed distress, a lack of social
support and fewer maladaptive but also less adaptive coping strategies
compared to parents with children with CI.
Conclusion: Relatives are an important resource for cancer patients; sup-
port is necessary.
Indication of source: (Optional, bitte löschen Sie diesen Absatz, wenn Sie keine
Quellenangaben haben):
References:
1 Zimmermann T. (2022). Partnerschaliche und familiäre Aspekte bei
Krebserkrankungen. Bundesgesundheitsbl, 65:446–452.
2 Mehnert A. et al. (2006). Die deutsche Version des NCCN Distress-
ermometers. ZPPP, 54:213–223.
3 Franke GH. (2017). Mini-Symptom-Checklist. Göttingen: Hogrefe.
4 Franke GH & Jagla M. (2016). Essen Coping Questionnaire. www.
psychometrikon.de.
5 Kocalevent R-D et al. (2018). Social support in the general population:
standardization of the Oslo social support scale (OSSS-3). BMC Psychology,
6:31.
Disclosure Statement: e authors declare no conict of interest.
219
Comparison of quality indicators between certied and
non-certied institutions based on data of the cancer registry
of Rhineland-Palatinate
Stefanie Schulz1; Hans Christian Lange2; Katharina Emrich2;
Christina Justenhoven2
1Onkologische Gemeinschaftspraxis Dres. Schulz, Bad Kreuznach, Deutschland
2Krebsregister Rheinland-Pfalz im Institut für digitale Gesundheitsdaten RLP
gGmbH, Mainz, Deutschland
Background: Publication of the results of the WiZen study initiated
a debate about quality of treatment in centers certied by the German
Cancer Society (Deutsche Krebsgesellscha, DKG) vs. non-certied insti-
tutions. We aimed to gain more information on this subject in Rhineland-
Palatinate and initiated a comparison based on quality indicators (QIs).
QIs are subject to S3-guidelines and represent an appropriate measure for
quality of treatment.
Methods: is study was based on data of the cancer registry of Rhineland-
Palatinate comprising the years 2016 to 2020. 19 QIs for breast, lung and
colorectal cancer were chosen according to their calculability with respect
to available data in the context of cancer registration in Germany. For each
QI compliance was analyzed for certied centers and non-certied insti-
tutions using the binominal test. e Soware SAS and R were used for
statistical analyses.
Results: e level of compliance of all analyzed QIs was higher in certied
centers compared to non-certied institutions. For 15 of the analyzed 19
QIs this dierence showed statistical signicance (p<0.005).
Discussion: Our results are in line with the assumption that treatment in
certied centers meet the recommendations of S3-guidelines more oen
than in institutions without certicate. One reasons for higher adherence
to guidelines could be a better management of the patients due to a multi-
disciplinary team including tumorboards.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts158
Conclusion: First results on a QI-based comparison in Rhineland-
Palatinate suggest better compliance to S3-guidelines in centers certied
by the German Cancer Society vs. institutions without certicate.
Disclosure Statement: e authors declare no conict of interest.
250
Patient-Centered Cancer Care: A Conceptual Framework
and Actionable Strategies for Comprehensive Cancer Care
Networks
Emily Hickmann; Peggy Richter
Technische Universität Dresden, Dresden, Deutschland
Background: In contemporary healthcare, the concept of patient-centered
care has emerged as a pivotal paradigm shi that redenes the tradi-
tional physician-centric model. Particularly in the context of cancer care,
marked by its intricate nature and emotional impact, theres a pressing
requirement to rethink how healthcare is delivered. In this context,
Comprehensive Cancer Care Networks (CCCNs) provide a new means
of structuring and providing quality cancer care, recognizing the unique
preferences and needs of each patient. To facilitate this patient-centered
approach in practice and advance care quality, it is essential to establish a
consistent denition and framework of patient-centeredness in a CCCN.
Methods: A systematic meta-review focusing on generic and oncolo-
gy-specic dimensions of patient-centeredness and a survey with key
stakeholders in the CCCN context were conducted.
Result: A denition and framework of patient-centeredness in CCCNs
is presented. e framework comprises eight primary dimensions:
Empowering patients, Engaging and Involving Patients, Treating the
Patient as a Unique Person, Enhancing the erapeutic Relationship,
Enhancing a Patient-Centered Culture, Providing Holistic Care,
Recognizing and Supporting the Caregiver as a Person and Coordinating
Care. Each dimension is supported by corresponding subdimensions and
actionable patient-centered activities.
Discussion: e results provide a comprehensive perspective on the
intricate elements that compose patient-centered care within CCCNs.
is can contribute to an improved and harmonized comprehension
of patient-centeredness in CCCNs, potentially leading to an enhanced
implementation of the concept in practice.
Conclusion: e results presented in this paper aspire to support CCCNs
in establishing a patient-centered environment where patients feel genu-
inely heard, valued, and actively engaged in their own care decisions.
e authors declare no conict of interest. is research was conducted in the
realm of the Joint Action CraNE and is funded by the European Union.
Disclosure Statement: e authors declare no conict of interest.
251
BMS-986158, a potent bromodomain and extraterminal
inhibitor (BETi), as monotherapy and in combination with
ruxolitinib or fedratinib, in intermediate- or high-risk
myelobrosis (MF): results from a phase 1/2 study
Haifa Al-Ali1; Rosa Ayala2; Nieves Lopez3; Adi Shacham Abulaa4;
Maan Alwan5; Costas K. Yannakou6; Indu Raman6; Vincent Ribrag7;
Chung Yew Fong8; Yulia Volchek9; Massimiliano Bonifacio10;
Alessandra Tucci11; Jean-Jacques Kiladjian12; Jésus María Hernández
Rivas13; Blanca Xicoy14; Jean-Christophe Ianotto15; Si Tuen Lee-Hoeich16;
Sharmilla Das17; Bin Wu16; Qian Zhao18; Oriana Esposito19; Yu Liu16;
Zariana Nikolova19; Christopher Tehlirian16; Shodeinde Coker18;
David Lavie20
1Universitätsklinikum Halle, Halle, Deutschland
2Hematology and Hemotherapy Department, Hospital Universitario 12 de
Octubre, CNIO, Complutense University, CIBERONC, Madrid, Spanien
3University Hospital October 12, Madrid, Spanien
4Beilinson - Helen Schneider Comprehensive Women‘s Health Center, Petah
Tikva, Israel
5Perth Blood Institute, West Perth, Australien
6Epworth HealthCare, Melbourne, Australien
7Département d‘Innovation Thérapeutique et d‘Essais Précoces (DITEP), Gustave
Roussy Institute, Villejuif, Frankreich
8Department of Haematology, Austin Health, Heidelberg, Australien
9Department of Hematology, Assaf Harofeh Medical Center, Zerin,
Zerin, Israel
10Department of Medicine, Section of Hematology, Verona University and
Azienda Ospedaliera Universitaria Integrata, Verona, Italien
11Hematology Unit, ASST Spedali Civili di Brescia, Brescia, Italien
12Centre d‘Investigations Cliniques (CIC 1427), Assistance Publique-Hôpitaux de
Paris, Hôpital Saint-Louis, INSERM, Université Paris Cité, Paris, Frankreich
13Department of Medicine, University of Salamanca, Department of
Hematology, Hospital Universitario de Salamanca, Salamanca, Spanien
14Hospital Universitari Germans Trias i Pujol, Barcelona, Spanien
15Centre Hospitalier Universitaire de Brest, Brest, Frankreich
16Bristol Myers Squibb, Cambridge, USA
17Bristol Myers Squibb, Princeton, USA
18Bristol Myers Squibb, Lawrenceville, USA
19Center for Innovation and Translational Research Europe, a Bristol-Myers
Squibb Company, Seville, Spanien
20Hadassah Medical Center, Jerusalem, Israel
Background: BMS-986158 is an orally bioavailable, potent, selective
small-molecule BETi currently evaluated in patients (pts) with MF in the
CA011-023 study (NCT04817007).
Methods: CA011-023 has a dose-escalation phase with BMS-986158 +
ruxolitinib (RUX) in RUX-naive pts (Part 1A) or BMS-986158 + fedrati-
nib (FED) in pts refractory, relapsed, or intolerant to RUX treatment (Tx)
(Part 1B). Planned doses for Part 1A are BMS-986158 2.0, 3.0, and 3.75
mg QD 5d on/2d o and RUX 15 mg BID. Planned doses for Part 1B are
BMS-986158 0.5, 0.75, and 1.25 mg QD 5d on/2d o and FED 400 mg QD.
Result: As of Sep 2, 2022, 23 pts were treated (Part A: 11 [median age
67 y (range, 36–81)]; Part 1B: 12 [69 y (37–77)]). Any grade (G) treat-
ment-related adverse events (TRAEs) occurred in 9 (82%)/9 (75%) pts in
Part 1A/1B. G3/4 TRAEs in Part 1A were thrombocytopenia (n = 5, 45%),
neutropenia, hypertension, and anemia (n = 1 each, 9%). G3/4 TRAEs in
Part 1B were thrombocytopenia, anemia (n = 5 each, 42%), diarrhea, and
blood bilirubin increase (n = 1 each, 8%). DLTs were reported in 2 pts in
Part 1A (both thrombocytopenia with dose reduction of BMS-986158 in
the 2.0 and 3.75 mg groups), and in 3 pts in Part 1B (diarrhea, thrombo-
cytopenia, and elevated bilirubin; all in the 1.25 mg group). Spleen vol-
ume reduction (SVR) was observed at wk 12 in Part 1A and continued to
deepen at wk 24. In Part 1A, 5/6 (83%) pts treated with BMS-986158 (2.0
or 3.0 mg) + RUX met SVR35 at wk 12; and 6/6 (100%) at wk 24. In Part
1B, 0/6 (0%) pts treated with BMS-986158 (0.5 or 0.75 mg) + FED met
SVR35 at wk 12; and 1/3 (33%) at wk 24. Pts in Part 1B vs 1A were treated
at lower BMS-986158 dose levels. JAK2 variant allele frequency analysis
showed reductions in JAK2V617F frequency in Parts 1A (41% max reduc-
tion, n = 7) and 1B (30% max reduction, n = 4).
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 159
Discussion: BMS-986158 with RUX or FED had acceptable and manage-
able safety proles; most TRAEs were G1/2 in severity.
Conclusion: Initial results show that BMS-986158 + RUX produced
robust SVR in pts with MF, with deepening responses beyond wk 12 with
continued Tx.
First published: Ayala R et al. HemaSphere 2023;7[S3]:S213.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
285
Pitfalls in interpreting patient reported outcome (PRO) results
in oncology trials: consequences of insucient data recording
Michael Köhler; Sascha Abbas
Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG), Köln,
Deutschland
Background: To demonstrate methodological aws of PRO documenta-
tion and analysis in clinical trials and the consequences for interpretation.
Methods: Examples from German benet assessments were used to
illustrate the problems of shortened observation periods for PROs (i.e.
European Organisation for Research and Treatment of Cancer Quality of
Life Questionnaires [EORTC QLQ] – Cancer 30 and – Breast Cancer 23)
in breast cancer trials (studies MONARCH 2 and MONARCH plus, com-
paring Abemaciclib + Fulvestrant to Fulvestrant alone). e consequences
for ecacy claims are discussed.
Result: e pharmaceutical company presented time-to-event analysis
of PRO outcomes dened as deterioration of 10 points without subse-
quent improvement. Statistically signicant advantages for Abemaciclib
were reported for several EORTC QLQ scales. However, PROs were only
recorded until end of treatment (e.g. due to disease progression) resulting
in a markedly shorter observation period compared with median over-
all survival time and a shorter observation period in the comparator arm
(73% [MONARCH 2] and 50% [MONARCH plus] compared to the inter-
vention arm). Conclusions can therefore only be drawn for the time until
progression. Due to the shorter observation period, deterioration without
subsequent improvement was potentially easier to achieve in the control
group. is results in a potential bias in favor of the intervention.
Discussion: Shortened and dierent observation periods between treat-
ment arms potentially introduce bias in PRO results. ese shortcomings
severely limit interpretability of study results and provide insucient data
on long-term PRO outcomes that are relevant for patients.
Conclusion: Trial sponsors should collect PRO data for as long as possi-
ble, i.e. until end of the study, to answer the relevant question – especially
from the patients’ perspective – whether patients do better or worse with
a specic drug in the long term.
Disclosure Statement: e authors declare no conict of interest.
322
Medical Quality Programs Department - A centralized unit
for quality assurance in oncology (and other specialties) at a
Swiss hospital for aliated physicians
Nora Woods; Stefan Heuser Preuvot
Klinik Hirslanden, Zürich, Schweiz
Background: e purpose of this abstract is to show under which cir-
cumstances it is possible to certify a medium-sized hospital (335 beds)
in German-speaking Switzerland, which functions predominantly as a
hospital for aliated physicians, as an oncology center according to the
German Cancer Society (DKG).
Methods/Result: e MQP department was launched in 2017, at that
time as the project “Tumorzentrum” at the Klinik Hirslanden in Zurich,
Switzerland. With a team of ve people (Head of Administration, three
Data Managers and a QMB), a breast as well as a prostate cancer center
were the rst to be established and certied according to DKG require-
ments. Since then, the center has been expanded to include a Visceral
Oncology Center (intestine, esophagus and pancreas), a Gynecological
Cancer Center, an Urooncology Center (prostate, kidney and urinary
bladder), a Hematologic Neoplasia Center, and a Neurooncology Center.
e center has been certied as an Oncology Center since 2018. Since
then, other medical programs with forms of verication such as certi-
cates from other specialties have been included in the departments’ scope.
Discussion: Challenges: Lack of hierarchy between clinic sta (MQP)
and attending physicians, drastic culture change for the physicians and
hospital, self-governance of physicians, competition between specialists.
Solutions: Commitment through contracts, jointly developed patient
pathways, collegial involvement, joint committees and escalation via
management.
Conclusion: Advantages for physicians and patients outweigh disadvan-
tages. Certication/regulation helps greatly with standardization along
the patient pathway.
Disclosure Statement: e authors declare no conict of interest.
371
Symptom clusters of oncological patients in specialist
palliative home care – What are their needs?
Daniela Gesell1; Farina Hodiamont1; Julia Wikert1; Eva Lehmann-Emele1,2;
Claudia Bausewein1; Friedemann Nauck2; Maximiliane Jansky2
1Klinik und Poliklinik für Palliativmedizin, LMU Klinikum, München, Deutschland
2Klinik für Palliativmedizin, Universitätsmedizin Göttingen, Göttingen,
Deutschland
Background: Specialist palliative home care (SPHC) aims to improve and
preserve the quality of life of patients with life threatening diseases. Little
is known about the needs and co-occurring symptoms of oncological
patients in SPHC. We therefore aim to analyze the prevalence of physi-
cal symptom burden and psychosocial problems, and the occurrence of
symptom cluster of oncological patients in SPHC.
Methods: Prospective, cross-sectional, multi center study collecting data
reecting the complexity of patients’ situations in SPHC. Descriptive
statistics on physical and psychosocial burden assessed by Integrated
Palliative care Outcome Scale at the beginning of a care episode (time
between admission and discharge or death). Exploratory and conrma-
tory factor analyses to identify symptom and problem cluster.
Results: We included 778 patient episodes from 9 teams, with 566 (72.8%)
oncological diagnoses, average age 73 (SD±12) years, 49.8% female, mean
length of episode 19.8 (SD±20) days. Main physical burden was weak-
ness (522/565;92.4%), poor mobility (472/562;84%) and poor appetite
(378/566;66.8%), main psychosocial problems were family (414/563;73.5%)
and patient anxiety (346/561;61.7%). ree symptom clusters (psychosocial,
physical, and practical) were identied, with at least one cluster shown in
172/566 (30.4%) episodes. Patient episodes with practical cluster had lower
age and higher functional status compared to all episodes.
Discussion: To provide adequate care to people at the end of their life
and to address their needs, it is necessary to understand how their symp-
toms might interact, and plan accordingly. In the community setting, the
practical cluster is of particular importance for the teams and their coor-
dination of care.
Conclusion: Consideration of symptoms or problems related to each
other in dierent ways and the corresponding needs can support care
planning.
Funding: G-BA Innovation Fund, no. 01VSF18018.
Disclosure Statement: e authors declare the following: Co-Autorin Prof. Clau-
dia Bausewein, Präsidentin der deutschen Gesellscha für Palliativmedizin.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts160
384
Remdesivir is associated with lower mortality in cancer
patients hospitalized for COVID-19 across emerging variants
Essy Mozaari1; Aastha Chandak2; Chidinma Chima-Melton3;
Andre C. Kalil4; Stephanie H. Read5; Celine Der-Torossian1; Lauren Dau1;
Rikisha Gupta1; Mark Berry1; Robert L. Gottlieb6
1Gilead Sciences, Foster City, USA
2Certara, New York, USA
3UCLA Health, Torrance, USA
4University of Nebraska Medical Center, Omaha, USA
5Certara, London, United Kingdom
6Baylor Scott & White Health, Dallas, USA
Background: Cancer patients with SARS-CoV-2 infection are at high risk
of progressing to severe COVID-19 disease, hospitalization, and mortal-
ity. We examined inpatient all-cause mortality for cancer patients hospi-
talized with COVID-19 and treated with remdesivir (RDV) vs. not across
pre-Delta, Delta and Omicron variant of concern (VOC) periods.
Methods: We identied adults with a cancer diagnosis (ICD-10-CM:
C00.x- C96.x) hospitalized with a primary diagnosis of COVID-19 from
US PINC AI Healthcare Database. Patients treated with RDV within 2
days of admission vs. not treated with RDV during hospitalization were
matched using 1:1 preferential within-hospital propensity matching with
replacement. Patients were excluded if discharged within 3 days of RDV
initiation. Cox Proportional Hazards Model was used to examine 14- and
28-day mortality.
Result: 4,937 RDV-treated patients were matched to 2,088 unique non-
RDV patients (equivalent to 4,937 non-RDV based on matching with
replacement). In the PS-matched cohort, unadjusted mortality rate was
signicantly lower for RDV-treated patients at 14 and 28 days (16% vs
25%; p<.0001 and 23% vs 31.5%; p<.0001) as compared to patients not
receiving RDV.
Aer adjusting for baseline and clinical covariates, RDV had a signi-
cantly lower mortality risk compared to non-RDV across all VOC periods
for 14- and 28-day results [overall (41% and 33% lower risk, respectively),
pre-delta (35% and 25%), Delta (39% and 32%), Omicron (48% and 40%)].
Discussion: In the PS-matched cohort of cancer patients hospitalized
with COVID-19, lower mortality rates for the RDV cohort were consist-
ently observed across all VOC periods.
Conclusion: In the vulnerable cohort of cancer patients hospitalized with
a primary diagnosis of COVID-19, patients treated with RDV within
2 days of admission had signicantly better survival outcomes. RDV
demonstrated consistent benet across all emerging variant periods of the
pandemic before Omicron BA4/5.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
391
Patient guidelines based on evidence-based oncological
clinical practice guidelines
Sarah Lisa Messer1; Annika Oeser1; Ulrike Holtkamp2; Gregor Wenzel3;
Markus Follmann3; Nicole Skoetz1
1Evidence Based Medicine, Department I of Internal Medicine, Faculty of
Medicine and University Hospital Cologne, University of Cologne, Köln,
Deutschland
2German Leukemia & Lymphoma Patients‘ Association, Bonn, Deutschland
3German Guideline Program in Oncology, German Cancer Society, Berlin,
Deutschland
Background: e purpose of oncological patient guidelines is to provide
understandable information for informed decision-making in cancer
management. Evidence-based oncological practice guidelines oer rec-
ommendations, but they are oen dicult to comprehend for laypersons.
us, patient guidelines are created. We outline the development process
of patient guidelines funded by the German Cancer Aid, using DLBCL as
an example.
Methods: First, an evidence-based oncological practice guideline is cre-
ated. Topics are reviewed and prioritised in collaboration with patients
and patient representatives. Using a strict standardized methodology and
a template provided by the German Guideline Program in Oncology, a
patient guideline is created: Recommendations are reworded for simplic-
ity, avoiding technical terms. A feedback loop with experts and patients is
initiated, and following a public consultation phase, the nal version of a
patient guideline is published online and in print.
Result: e DLBCL patient guideline covers key practice guideline recom-
mendations in accessible language for patients and caregivers. It includes
various topics, especially therapy and follow-up care. e rst feedback
round is underway, and the consultation version is expected by February.
Discussion: Patient guidelines bridge complex oncological clinical prac-
tice guidelines and patient information needs, making information under-
standable and accessible. is accessibility empowers patients to actively
participate in their own care decisions.
Conclusion: e DLBCL patient guideline serves as an example for the process
of creating patient guidelines. All patient guidelines developed in the German
Guideline Program in Oncology, follow the same method. Ultimately, patient
guidelines play a crucial role in supporting patient-centred care by providing
clear and accessible information to aid informed decision-making.
Disclosure Statement: e authors declare no conict of interest.
419
Feasibility and learning outcomes of Lübecks
interprofessional training ward (LIPSTA): a mixed-methods
evaluation
Frederike Lüth1; Max Moll2; Birte Hildebrand1; Niklas Gebauer3;
Martina Traut4; Nikolas Christian Cornelius von Bubno3; Katrin Balzer1
1University of Lübeck, Institute for Social Medicine and Epidemiology, Nursing
Research Unit, Lübeck, Deutschland
2University of Lübeck, Student body of medicine and health care, Lübeck,
Deutschland
3University Hospital of Schleswig-Holstein, Campus Lübeck, Department of
Hematology and Oncology, Lübeck, Deutschland
4University Hospital of Schleswig-Holstein, Campus Lübeck, Central institution
for physiotherapy and physical therapy, Lübeck, Deutschland
Background: An important aim of health professionals’ education is to
promote competencies for interprofessional collaboration in clinical prac-
tice. erefore, the Lübeck interprofessional training ward (LIPSTA) was
implemented in the department of hematology and oncology in 2022.
During four-week joint assignments, students of nursing, human med-
icine and physiotherapy work together to care for several patients inde-
pendently under the supervision of professionals. Each LIPSTA rotation
has been evaluated to examine acceptance, feasibility and learning out-
comes of this placement model.
Methods: Mixed-methods evaluation with pre-post-design: Students
(nursing n=7, medicine n=4, physiotherapy n=2) subjective interprofes-
sional competencies and satisfaction with the placement were surveyed at
several measurement points. Qualitative interviews were conducted with
students (n=10) and supervisors (n=7) aer each placement.
Result: Self-reported competencies in interprofessional collaboration
(Interprofessional Socialization and Valuing Scale, 1=very low, 7=very high)
increased from mean 5.2 (standard deviation (SD) 0.6) to 6.0 (SD 0.6) from
the beginning to the end of the placement. Qualitative data suggest distinct
improvements in interprofessional communication and teamwork. All
involved parties including patients welcomed this placement model while
professionals emphasized the eorts required for successful implementa-
tion. No adverse events attributable to the LIPSTA placement were noted.
Discussion: LIPSTA proved to be safe, feasible, and eective. However,
as the model is currently limited to one clinical department, only a few
students could benet from it.
Conclusion: e LIPSTA model holds high chances for the quality of edu-
cation and patient care and should become normalized routine in clinical
placements of health profession students.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 161
476
OncoBox-Compare – external data quality check for prostate
cancer centers and cancer registry
Katharina Weinert1; Philipp Kachel1; Sebastian Dieng2
1Krebsregister Rheinland-Pfalz im Institut für digitale Gesundheitsdaten, Mainz,
Deutschland
2OnkoZert, Neu-Ulm, Deutschland
Background: DKG-certied prostate centers record according to the
certication requirements and additionally report to their State Cancer
Registry in the format of the Oncological Basic Data Set (oBDS, www.
basisdatensatz.de). e pilot project initiated by OnkoZert (OZ) and the
Cancer Registry Rhineland-Palatinate (KR RLP) in cooperation with the
prostate cancer centers Trier and Ludwigshafen established a novel exter-
nal data quality check. e main objective was to understand the discrep-
ancy between data use for certication and reporting to KR RLP and to
gain insights on how to reduce documentation eorts in the long term.
e focus was on data quality.
Methods: e comparison between center and KR RLP data was based
on selected patient and tumor information using a common denition as
center case” and was performed with the soware application “OncoBox-
Compare” (xml interface) implemented in the project, which allows anal-
yses on patient collective, case and eld level. e data format used was
the OncoBox prostate report (xml interface). e case group included
center patients with non-metastatic prostate cancer diagnosed in 2019,
discussed in the pre-therapeutic tumor conference, and treated at the
prostate center.
Result: For both centers, match at the patient collective level was greater
than 90%. is allowed verication of the centers’ case counting, eld-
level analyses and clarication of lost-to-follow-up cases using informa-
tion from the cancer registry data exchange.
Discussion: Match at the patient and tumor level is highly dependent on
match factors such as the indicator year or primary case count and is the
result of specic calculations.
Conclusion: Although the data elds dier between DKG certication
specications and oBDS, data reconciliation is possible. e joint anal-
ysis intensied the communication between center and cancer registry,
strengthened the trust and increased the data quality. e further approx-
imation of the data elds of the OncoBoxes to the oBDS makes sense and
was done for the new OncoBox Lung.
Disclosure Statement: e authors declare no conict of interest.
560
Speechlessness in Oncology: Inuence of Receiving
an Oncological Diagnosis -Results of a Prospective
Longitudinal Study
Thilo Dietz1; Vera Schiewer1; Johannes Bösche2; Eva Schneider2; Sarah-
Michêle Spielmann2; Anika Rütjes2; Frank Dracke2; Michael Kusch1
1Department of Internal Medicine, University Hospital Cologne, Köln,
Deutschland
2Oncology Nursing Department, Nursing Directorate, University Hospital
Cologne, Köln, Deutschland
Background: e Phenomenon of Speechlessness, measured by the
lner Fragebogen zur Sprachlosigkeit (KFS) [1] can be divided into an
intentional, a non-intentional and an emotional dimension. Extreme
emotional situations are considered central to emergence of speech-
lessness. Preliminary data suggest a signicant prevalence of emotional
speechlessness in oncology patients up to 5 years aer diagnosis [2]. ere
are no studies on whether an oncological diagnosis is a cause of speech-
lessness and whether it decreases during the course of the disease.
Methods: From June 2022 to August 2023, a prospective longitudi-
nal study was conducted including adult patients with an oncological
diagnosis within the last 120 days. Data was collected over three time
points (T1 to T3) with an interval of 60 days using the KFS [1].
Result: A total of N= 51 patients were enrolled (43% provided com-
plete information); the mean time from diagnosis to T1 was M = 43.24
(SD = 36.22) days. Results of a rmANOVA with Bonferroni correction
showed a significant increase in emotional speechlessness between T1
and T2 (6.7; F = 4.651; p = .027). Intentional and non-intentional
speechlessness remained unchanged between T1, T2 and T3. Results of
linear regression analysis indicated no significant influence of the time
between diagnosis and the expression of speechlessness at T3.
Discussion: e results indicate that receiving an oncological diagnosis
leads to an increase in emotional speechlessness, while intentional and
non-intentional speechlessness remain unchanged.
Conclusion: e results support the notion that a cancer diagnosis is a
highly emotional event that causes speechlessness.
Indication of source:
1 Dietz,T. et al. (2022). Cologne questionnaire on speechlessness: Development
and validation. Current psychology, 1–12.
2 Dietz,T. et al. (2022). Caught in Speechlessness: First insights in patients with
oncology diseases. In 35. Deutscher Krebskongress, Krebsmedizin: Schnittstellen
zwischen Innovation und Versorgung, 23–26. Februar 2022, Berlin.
Disclosure Statement: e authors declare no conict of interest.
582
Patient and caregiver perspectives in hepatobiliary cancer
Raphael Mohr1; Reiner Lehmann2; Helen Beckmann3
1Charité - Universitätsmedizin Berlin, Medizinische Klinik m. S. Hepatologie und
Gastroenterologie, Berlin, Deutschland
2DontBePatient Intelligence GmbH, Hamburg, Deutschland 3AstraZeneca
GmbH, Hamburg, Deutschland
Background: In cancer therapy, perspectives of patients and caregivers
are highly important and should be included in treatment decisions. For
hepatocellular carcinoma (HCC) and biliary tract cancer (BTC), these
data are largely missing. New approaches to collect these data reliably can
be helpful to improve care of hepatobiliary cancers. We here conducted a
social media survey to gain better insight into the needs and expectations
of HCC and BTC patients and their caregivers.
Methods: An online survey distributed via social media was conducted,
with a detailed questionnaire assessing the diagnostic and therapeutic
patient journey, including quality of life (QoL) parameters, and the psy-
chological burden for patients and caregivers.
Result: 340 people (80 patients and 260 caregivers) completed the sur-
vey. 61% of patients considered QoL and long-term survival as equally
important. 64% of patients wished that their relatives/caregivers would
be involved in treatment decisions, and 45% of caregivers wanted to be
involved to a greater extent in therapeutic decision making. With an
EQ-5D-5L index score of 0.718, QoL of patients was generally low. With a
mean BSFC-s score of 16, there was a high burden on caregivers. Although
73% of the survey participants use the internet frequently and intensively
to obtain disease-related information, 61% did not know that there are
cancer support programs where they can seek help and counseling.
Discussion: Our results highlight the importance of patient and caregiver
perspectives for implementing a modern, holistic, individualized and
patient-centered care in hepatobiliary cancer. Due to the heterogeneity of
the analyzed population and the small sample size, interpretation of data
should be performed with caution.
Conclusion: In this social media-based survey, comprehensive data on
patient and caregiver perspectives in HCC and BTC point to a medi-
cal need to improve QoL and reduce the burden to caregivers. ere is
a high demand for more patient/caregiver information, education, and
involvement.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts162
591
Image-guided options in malignant tumor growth of the
visceral medicine - representative case series
Udo Barth1; Frank Meyer2; Jazan Omari3; Zuhir Halloul1
1Division of Vascular Surgery; Dept. of General, Abdominal, Vascular and
Transplant Surgery; University Hospital, Magdeburg, Deutschland
2Dept. of General, Abdominal, Vascular and Transplant Surgery; University
Hospital, Magdeburg, Deutschland
3Dept. of Radiology and Nuclear Medicine, University Hospital, Magdeburg,
Deutschland
Background: Visceral diseases may appear complex, in particular, if they
have a vascular dimension.
Aim/Methods: Practice-relevant demonstration of an exemplary case
series w/ case-specic characteristics.
Result (cases):
1) Male pat. (72 yrs. old) w/ primary iliaco- & subsequently mesenterico-
enteral stula w/ recurrent bleedings due to inltrating Tu growth
(rectal Ca) leading subsequently to: i) right AIE stenting, ii) coiling
of right AIC/AII branches, iii) local Tu/stula excision + right AIE
ligation.
2) Male pat. (70 yrs. old) w/ AEG-Tu type II + esoph. inltration lead-
ing to gastrectomy, splenectomy & esoph. resection + colon-segment
interposition (histology: pT2aN1[1/18]L1V1G3) - SEMS for subse-
quent anastomotic insiuciency; later: “high-ow“-aortoesoph. stula
w/ hemorrhage into esoph. lumen.
3) Male pat. (79 yrs. old) w/ ureteroiliac stula & hematuria; catheteriza-
tion of actinic ureteral strictures due to neoadj. radiochemoTx (sub-
sequently, abdominoperineal rectum exstirpation (suprasphinctary
cancer, ypT3ypN0M0) w/ Amplatzer insertion into right AII & iliac
stenting from le AFS (“cross-over maneuver“).
4) Male pat. (78 yrs old) w/ right hemicolectomy due to Ca of ascending
colon (med. history; signicant for CMI w/ arteriosclerotic stenoses of
all 3 mesenteric arteries leading to PTA of all 3 mesenteric arteries &
stenting of AMS) & re-laparotomy for lavage.
5) Male pat. (82 yrs. old - severe risk factors) w/ metastasizing Ca of
the papilla of Vater - local bleeding w/ image-guided cessation of the
bleeding by means of prox. & dist. coiling of the bleeding site at periph.
branches of the sup. et inf. pancreaticoduod. arteries.
Conclusion: Measures comprise i) stenting/prelesional coiling for cessa-
tion of bleedings, ii) PTA/stenting in mesenteric arteriosclerosis (acute/
chronic mesenteric ischemia) for recanalization, iii) stenting in case of
aneurysm/dissection, iv) injection of substances in (pseudo-)aneurysm.
Disclosure Statement: e authors declare no conict of interest.
619
Mid-term nding after pancreatic trauma mimics pancreatic
tumor lesion
Kilian Dossow1; Frank Meyer1; Sara Acciu1; Christine March2;
Aristotelis Perrakis1; Roland Croner1; Sara Al-Madhi1
1Dept. of General, Abdominal, Vascular and Transplant Surgery; University
Hospital, Magdeburg, Deutschland
2Dept. of Radiology and Nuclear Medicine, University Hospital, Magdeburg,
Deutschland
Background: Pancreatic tumor lesion can be considered a demanding
dierential diagnosis.
Methods: Scientic case report.
Result: (CASE DESCRIPTION):
Medical Hx: - CURRENT: 57-years old male patient was presented with
tumor(-like) lesion of the pancreas of unclear dignity in CT scan per-
formed for staging purpose of a histologically diagnosed prostate cancer;
no complaints or “B-symptomatology” (status aer abdominal trauma &
posttraumatic conservatively treated pancreatitis in 2020 [1.5 years ago])
Secondary diagnoses: Prostate cancer (rst diagnosis, 06/2021) with open
prostatectomy
Clinical nding: Good clinical & normosome nutritional as well as car-
diopulmonarily compensated status; abdominal wall so, no muscular
defense, scar of a median laparotomy w/o inammatory signs
Diagnostic measures: - LAB: No elevated inammatory, cholestasis param-
eters & tumor markers (CA19-9: < 9 U/mL, CEA: 2.4 ng/mL) - GLDH
minimally elevated
oracic/Abdominal CT scan (in a dierent hospital): Fluid formation
within the pancreatic corpus, no clear tumor lesion, no cholestasis
EUS: Semiliquid area within the isthmus, the remaining pancreas with
no nding
Histopathology (of transgastric puncture probe): Pancreatic necrosis with
slight hint for malignancy.
Clinical course: Aer uncomplicated EUS-guided puncture, case was
repeatedly presented in tumor board conference incl. polytrauma-related
images with declining local nding.
Diagnosis: Fluid formation within the pancreatic corpus aer traumatic
pancreatic contusion and posttraumatic pancreatitis.
Dierential diagnosis: Pseudocyst, cystic (serous-cystic, mucinous-cystic)
pancreatic lesion.
erapy: Conservative approach
Proceeding: Control imaging using ultrasound aer 3 months incl. pros-
tate cancer.
Conclusion: Abdominal trauma is a not rarely occurring clinical event/
nding in the emergency room with a broad spectrum of clinical aspects,
which can be considered a challenge for the abdominal surgeon (as in the
presented case.
Disclosure Statement: e authors declare no conict of interest.
620
First Analysis of Quality of Life and Patient Satisfaction of
Molecular Oncology Patients in Germany– the Cross-sectional
Molecular Tumour Board Freiburg Analysis
Linda Gräßel1; Michael Kruszewski1; Julia Kühn1; Rebeka Javorniczky1;
Katharina Herzog2; Julius Wehrle1; Johannes Jung1,3,4; Henriette Bertemes1;
Martin Werner5,6; Justus Duyster1,5,7; Mtb-Fr Network5;
Cornelius Miething1,5; Melanie Börries5,7,8; Lena Illert1,3,4,5,7
1Department of Hematology, Oncology and Stem Cell Transplantation, Faculty
of Medicine, Freiburg University Medical Center, Freiburg, Deutschland
2Insitute for Human Genetics, University Medical Center Innsbruck, Innsbruck,
Österreich
3Clinic and Polyclinic for Hematology and Oncology, Faculty of Medicine,
Technical University of Munich, München, Deutschland
4Center for Personalized Medicine, Klinikum r.d. Isar, Technical University
Munich, München, Deutschland
5Comprehensive Cancer Center Freiburg, Faculty of Medicine, Freiburg
University Medical Center, Freiburg, Deutschland
6Department of Pathology, Faculty of Medicine, Freiburg University Medical
Center, Freiburg, Deutschland
7German Cancer Consortium (DKTK), Partner site Freiburg; and German Cancer
Research Center (DKFZ), Heidelberg, Deutschland
8Institute of Medical Bioinformatics and Systems Medicine, Freiburg University
Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
Deutschland
Background: e Molecular Tumor Board Freiburg (MTB-FR) aims to
identify and evaluate potential targets for personalized therapy in can-
cer patients with mostly advanced disease and limited to no conventional
therapeutic options. Aim of this study is to dene the subjective thera-
peutic benet by analyzing patient-reported outcome measures (PROMs)
such as quality of life (QoL) and patient satisfaction.
Methods: We conducted a paper-based survey in a cross-sectional design
to analyze PROMs of the participants of the Molecular Tumor Board
Freiburg registry trial. We adapted the pre-existing German version of
the Patient Satisfaction with Cancer-related Care (PSCC-G) for patients
undergoing molecular diagnostics and treatment recommendation in a
molecular tumor board (mPSCC-G). Health-related (HRQoL) and can-
cer-specic quality of life were assessed by using the validated and widely
used EQ-5D-5L and EORTC-QLQ-C30 respectively.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 163
Result: e patient characteristics of the 101/257 (=39.3%) evaluable
responses reected our entire cohort of MTB-FR registry study partic-
ipants. mPSCC-G analysis showed high overall satisfaction of MTB-FR
participants, with 76.2% stating that case discussion at MTB-FR was ben-
ecial to them. EQ-5D-5L and EORTC-QLQ-C30 analyses indicate that
HRQoL is higher in patients receiving therapy recommended by the MTB.
In addition, patients receiving personalized treatment tend to report lower
symptom burden and higher functional scores.
Discussion: In addition to OS/PFS, PROMs should be collected more
widely, placing patient-centered care at the heart of the treatment pro-
cess for patients with advanced cancer. To ensure that as many patients as
possible benet from this diagnostic tool, it is essential that patients are
enrolled in a MTB in a timely manner.
Conclusion: To the best of our knowledge, this is the rst structured anal-
ysis of patient satisfaction and QoL of participants in a molecular tumor
board registry trial in Germany demonstrating the subjective therapeutic
benet of patients.
Disclosure Statement: e authors declare no conict of interest.
629
Plato2: Nationwide Platform for linking and analysing
Oncology Research Data
Sylke Zeissig1; Monika Klinkhammer-Schalke1; Benjamin Barnes2;
Johannes Bruns3; Bianca Franke1; Tobias Hartz4; Anne Hennings1;
Hedy Kerek-Bodden5; Jan Krischan Krause3; Klaus Kraywinkel2;
Gerd Nettekoven6; Olaf Ortmann1,3; Thomas Seuerlein3;
Kerstin Weitmann4; Simone Wesselmann3; Stefan Rolf Benz1
1Arbeitsgemeinschaft Deutscher Tumorzentren e.V., Berlin, Deutschland
2Zentrum für Krebsregisterdaten am Robert-Koch-Institut, Berlin, Deutschland
3Deutsche Krebsgesellschaft e.V., Berlin, Deutschland
4Plattform § 65c, Magdeburg, Deutschland
5Haus der Krebs-Selbsthilfe – Bundesverband e.V., Bonn, Deutschland
6Deutsche Krebshilfe, Bonn, Deutschland
Background: For a nationwide, event-related compilation and evaluation
of oncological data, a platform is needed that is professionally supported
with experience in clinical-scientic evaluations. To answer specic ques-
tions, the cancer registry data should be linked with other relevant data
in order to gain new scientic knowledge. In addition, the platform will
provide an infrastructure for prospective registry based trials. e Act on
the Compilation of Cancer Registry Data (Gesetz zur Zusammenführung
von Krebsregisterdaten (KRDa-ZuG)) supports the establishment of this
platform.
Methods: We chose six use cases on topics and entities to form the basis of
our investigations. Interdisciplinary expert teams are currently analysing
the necessary steps and proposed solutions. For each use case the data
requirements will be identied and the suitability of the data set link-
age will be evaluated on the basis of the applicable regulations especially
under current federal/ state law.
Result: e project is currently in development phase. First step is to take
stock of the current situation. It will be examined which questions can
already be dealt with today available data, which projects would only be
feasible with a very high eort and which would not be feasible at present
and need data linkage with other data sources.
Discussion: e Phase 2 platform concept seeks to enable timely and
accessible nationwide inquiries and evaluations of specic research ques-
tions in clinical cancer medicine. e realm of research questions that can
be addressed using healthcare data will thus be continuously expanded.
Conclusion: e project’s results will facilitate retrospective and pro-
spective evaluations using study and routine data for healthcare research
and clinical therapies, further advancing the eld. By lever-aging the
Plato2 platform, we strive to enhance healthcare outcomes and informed
decision-making.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
634
Informationsbedürfnisse von Patient*innen mit
fortgeschrittenem Lungen-, Ösophagus- und Leberkarzinom -
Ergebnisse eines Realist Reviews im Projekt Onco:cide
Stephan Nadolny1,2; Lydia Ilin3; Christian Heise4; Johannes Porzelle5;
Julia Roick3; Matthias Richter3; Patrick Michl4; Henning Rosenau5;
Jan Schildmann1
1Institut für Geschichte und Ethik der Medizin, Prolzentrum
Gesundheitswissenschaften, Medizinische Fakultät, Martin-Luther-Universität
Halle-Wittenberg, Halle, Deutschland
2Institut für Bildungs- und Versorgungsforschung im Gesundheitsbereich,
Hochschule Bielefeld, Bielefeld, Deutschland
3Lehrstuhl für Soziale Determinanten der Gesundheit, Fakultät für Sport- und
Gesundheitswissenschaften, Technische Universität München, München,
Deutschland
4Klinik für Gastroenterologie, Infektionskrankheiten und Vergiftungen,
Universitätsklinikum Heidelberg, Heidelberg, Deutschland
5Interdisziplinäres Zentrum Medizin – Ethik – Recht, Juristische und
Wirtschaftswissenschaftliche Fakultät, Martin-Luther-Universität Halle-
Wittenberg, Halle, Deutschland
Background: e decision-making ability of people with cancer can be
compromised by several factors. A variety of interventions have been
developed to improve decision-making. Professionals perceive them as
conicting with existing practice, resource intensive and therefore the
degree of implementation is low.
e project aims to optimize the existing informed consent process with a
low-threshold, multimodal intervention. A realist review was conducted
to provide a theoretical basis. One research question focuses on the infor-
mation needs of patients throughout the disease trajectory.
Methods: We searched Medline, Cinahl, PsycInfo, Web of Science and
Scopus from 2005 to October 2022. We included studies focusing on
the information needs of patients with lung, esophageal and liver cancer
regardless of the study design or setting. Two researchers independently
screened and extracted the data. We analyzed the data with respect to the
dierent information needs at dierent stages of the disease process (diag-
nosis, treatment, post-treatment, end of life) as well as cancer progression.
Result: Database search yielded 1022 articles. Aer title and abstract
screening 111 remained and 60 studies were included in the analysis
aer screening full texts. Most studies (n=30) focused on the diagnosis
and treatment phase and only a minority on the end-of-life phase (n=5).
Important information needs are prognosis, treatment options, cancer
symptoms, side eects, coping and self-care. e need for information
on treatment options decreases over the disease trajectory with a greater
focus on coping and self-care in the post-treatment phase.
Discussion: Patients need varying information over the course of their
disease. Due to heterogeneous reporting, it was dicult to dierentiate
the information needs in relation to cancer progression or staging.
Conclusion: More emphasis should be placed on coping and self-care at
an early stage, e.g. to build resilience, as it can be challenging for cancer
patients to anticipate their needs when they are preoccupied with treat-
ment decisions.
Disclosure Statement: e authors declare no conict of interest.
635
Surveillance and eld service improve quality and quantity in
the Rhineland-Palatinate Cancer Registry
Petra Plachky; Katharina Weinert; Philipp Kachel
Cancer Registry of Rhineland-Palatinate in the Institute for Digital Health Data
RLP gGmbH, Mainz, Deutschland
Background: Clinical-epidemiological cancer registration serves as
key driver in monitoring and improvement of oncological treatment in
Germany. In this context close interaction between cancer registries and
physicians is mandatory. One parameter is to supply main information on
a cancer patient with minimal eort for the inquiring physician. For this
aim the cancer registry in Rhineland-Palatinate developed the oncological
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts164
patient record (onkologische Patientenakte, oPA) a unique service which
comprises a chronological merge of main information on each tumor
diagnosis, treatment and follow-up. is includes reports from physicians
from other federal states. e oPA can easily be retrieved via personal
login of physicians even on the reporting portal of the cancer registry.
Methods: Cancer registration in Germany follows the recommendations
of the unique oncological basis dataset. In accordance to these specica-
tions the database of the cancer registry in Rhineland-Palatinate provides
epidemiological and clinical data from 1997 and 2016 on, respectively.
us, this database consists of several million data points. is huge
amount of data is structured and included as a summary of the best infor-
mation in the oPA. e number of meanwhile available records was cal-
culated by R.
Result: As of yet the cancer registry of Rhineland-Palatinate provides an
oPA for more than 200.000 tumors, this represents about 65 % of clinically
reported tumors.
Discussion: One obligation of cancer registration in Germany is the sup-
port of physicians with comprehensive information on cancer patients.
Since cancer diagnosis and treatment occurs multidisciplinary and
involves specialists in dierent institutions it is necessary to centralize all
information in a structured way on one platform. Accordingly, the oPA
was established in Rhineland-Palatinate.
Conclusion: e oPA provides a unique service for physicians to obtain
crucial information on cancer patient on a condensed level and with easy
access.
Disclosure Statement: e authors declare no conict of interest.
646
PromotingPhysicians‘ Communicative Competence and
Performance(KPAP Study, funded by DKH) - Results on
Self-Ecacy and Burnout Symptoms
Isabel Hamm1; Frank Vitinius1; Bernd Sonntag1; Wolfgang Söllner2;
Stephanie Stock3; Wolf Langewitz4; Alexander Wünsch5; Martin Hellmich6;
Hannah Fischer1; Nadine Haupt1; Barbara Stein7
1Klinik und Poliklinik für Psychosomatik und Psychotherapie,
Universitätsklinikum Köln, Köln, Deutschland
2Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
3Institut für Gesundheitsökonomie und Klinische Epidemiologie,
Universitätsklinikum Köln, Köln, Deutschland
4Psychosomatische Medizin, Universitätsspital Basel, Basel, Schweiz
5Inselspital, Universitätsspital Bern, Universitätsklinik für Medizinische
Onkologie, Bern, Schweiz
6Institut für Medizinische Statistik und Bioinformatik, Universität zu Köln, Köln,
Deutschland
7Klinik für Psychosomatische Medizin und Psychotherapie, Klinikum Nürnberg,
Nürnberg, Deutschland
Background: Eective communication between oncology physicians and
patients is critical to quality cancer care. Ineective communication can
lead to psychological distress, professional dissatisfaction, and burnout
symptoms in physicians. e project KPAP (Promoting Communicative
Competence and Performance of Physicians and Patients), funded by
German Cancer Aid, aims to evaluate long-term eects of a communica-
tion training program for oncology physicians. Results on self-perceived
self-ecacy and burnout symptoms will be reported.
Methods: e communication training consists of 2.5 days interactive
training with a refresher session (at least three months aer the basic
training). It includes role-playing with actor patients, based on chal-
lenging conversational situations of the participants. Self-assessments of
self-ecacy and burnout symptoms were collected at the beginning (t0)
and end (t1) of basic training, during the refresher session (t2), and at least
3 years aer attending the basic training (t3). Self-ecacy is assessed with
an adapted questionnaire from Falloweld, Lipkin, and Hall and burnout
symptoms with the Maslach Burnout Inventory. Repeated measures anal-
yses of variance and mediation analyses will be conducted.
Result: From 2015 to 2019, 20 communication trainings were conducted
with 209 physicians in Cologne. Long-term follow-up surveys have been
conducted since 2019. Recruitment and implementation of t3 were com-
plicated by the occupational mobility of participants and the Covid-19
pandemic. Long-term data from t0 and t3 for self-ecacy and burnout are
available for 89 participants and will be reported at the conference
Discussion: e study is providing valuable insights into the long-term
eects of this training. Results on self-ecacy and burnout will be an
essential part of the assessment of its eectiveness.
Conclusion: e long-term data will be used to make recommendations
for the design and frequency of future trainings.
Disclosure Statement: e authors declare no conict of interest.
664
The Center for Integrated Oncology (CIO) Cologne Summer
Academy- an innovative oncology teaching program for high
school students
Viktoria Kohlhas1; Ida Dareskog2; Jürgen Wolf3; Cornelia von Levetzow4
1CIO Cologne/Department I of Internal Medicine/University Hospital of
Cologne/Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf
(CIO ABCD), Cologne, Deutschland
2CIO Cologne, University Hospital Cologne, Center for Integrated Oncology
Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Deutschland
3Department I of Internal Medicine/CIO Cologne/University Hospital of
Cologne/Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf
(CIO ABCD), Cologne, Deutschland
4CIO Cologne, University Hospital Cologne, Center for Integrated Oncology
Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Deutschland
Background: As a CCC, e CIO wants to provide an excellent teaching
infrastructure for oncology training. Inspired by the Summer Academies
of US-American cancer centers, we launched the rst CIO Summer
Academy in 2014 with 5 students and have expanded the program in
subsequent years to up to 12 students. Our goal was to give talented and
motivated high school students the opportunity to get a deep insight into
translational cancer research in order to encourage them to pursue careers
in the eld of cancer research.
Methods: Students experienced four weeks of research-focused didactic
and experiential learning in dierent laboratories and a clinical trial oce.
ere, the scholars worked individually on their own research projects
and attended a series of cancer biology lectures presented by young sci-
entists of the CIO, also improving the lecturers’ teaching skills. At the end
of the program, scholars presented their projects orally, as well as during
a poster session.
Result: During the 9 years, 66 students have participated in this program
and learned important skills to help prepare them for success in their
future careers in science and medicine. e annual evaluation helped to
improve the program contents. On feedback surveys, the students were
highly enthusiastic about this opportunity of having such a deep and
application-oriented insight into translational cancer research.
Discussion: We believe that this program represents a model for inspir-
ing students to focus on translational cancer research. Accordingly, 12
of the former participants already worked as student helpers in research
groups of our CCC. Participants from the rst years are now working on
their doctoral theses and have completed research stays at international
institutions.
Conclusion: We are convinced that such a program is extremely useful
to give students the opportunity to get an insight that is otherwise only
possible at the end of their studies at the earliest. is has been successful
in conveying enthusiasm for the complex interrelationships in oncology
and in attracting participants to this subject.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 165
693
Analysis of the implementation of the Uniform Oncology
DataSet in physicians’ letters at CIO Cologne
Vanessa Schulz1; Scarlett Berressem1; Wolfgang Schröder2;
Axel Heidenreich3; Thomas Zander4; Jürgen Wolf4
1CIO Cologne, University Hospital Cologne, Center for Integrated Oncology
Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Deutschland
2Department of General, Visceral Surgery, and Surgical Oncology, University of
Cologne, Cologne, Deutschland
3Department of Urology, Uro-Oncology, Robot-Assisted and Specialized
Urologic Surgery, Faculty of Medicine and University Hospital Cologne,
University of Cologne, Cologne, Deutschland
4Department I of Internal Medicine, University of Cologne, Center for Integrated
Oncology Aachen Bonn Köln Duesseldorf (ABCD), Cologne, Deutschland
Background: Physicians in NRW are legally obligated to report oncolog-
ical cases to the state cancer registry and are supported in this by trained
data managers. Physician letters (PL) are a central source but do not have
to contain all obligatory contents of the Uniform Oncology Data Set
(UODS). Nevertheless, completeness is a helpful chance to reduct per-
sonell costs for tumordocumentation. is work analyzes the status of
reportable information in already very high-quality PL, to identify possi-
ble center-specic potential for improvement.
Methods: A randomly selected ten percent sample of PL from the CIO was
analyzed with regard to documentation completeness using prospectively
dened main and subcategories of the contents of the mandatory UODS.
262 PL of newly diagnosed patients of the year 2021 were examined.
Result: Highest rates for overall completeness were found in the
Esophageal cancer center. e average of all centers was about 50%.
With regard to the main categories “residual status and “conrmation
of diagnosis”, almost all certied centers were able to achieve between 80
and 100%. e Prostate center achieved a 100% documentation rate in
the before mentioned main categories. Decits were oen found in the
main categoriessurgeon (name)”, “tumor conference”, “therapy recom-
mendation”, and “additional contacts.
Discussion: Ratios of 50% can be considered positive since many UODS
contents do not necessarily have to be found in the PL. Yet there seems to
be room for improvement in selected clinics, especially in the adoption of
therapy recommendations in the PL. e same applies to additional con-
tacts such as information about psycho-oncological support.
Conclusion: e investigations show a high number of UODS-relevant
contents in the CIO PL. Nevertheless, potential for improvement was
identied. Simple modications in the form of structured text modules or
automatic transfers of certain clinical information could help by oering
physicians an ecient way to improve decits.
Disclosure Statement: e authors declare no conict of interest.
714
Support of Certied Centers – Comprehensive Service of the
Cancer Registry of Rhineland-Palatinate
Christina Justenhoven1; Jan Helge Folkerts1; Heinz Kirchen2;
Alexander Desuki3
1Cancer Registry of Rhineland-Palatinate in the Institute for Digital Health Data
RLP gGmbH, Mainz, Deutschland
2Hospital Barmherzige Brüder Trier, Trier, Deutschland
3University Cancer Center Mainz (UCT Mainz), University Medical Center of the
Johannes Gutenberg-University Mainz, Mainz, Deutschland
Background: Cancer registries have been established in each federal state
in Germany. One statutory obligation of cancer registries is the support of
cancer centers. Accordingly, the cancer registry of Rhineland-Palatinate
compiled a catalogue of services which are provided to oncological
centers. ese services aim to support certication processes as well as
accomplishment of individual requests.
Methods: Number of provided services, such as datasets, reports, analyses
and presentations were calculated and correlated to the number of certi-
ed centers in Rhineland-Palatinate in the time-period 2018-2023.
Result: e number of certied centers increased from 47 to 69 in the
years 2018 to 2023 in Rhineland-Palatinate. During this time period more
than 280 datasets were transferred to oncological centers. In addition to
more than 150 automatically generated reports per year centers are sup-
ported by individual analyses. Yearly invitation to quality conferences is
standard as well as support of dierent events organized by the centers
(e.g. audits) with presentations by members of the cancer registry.
Discussion: Publication of the results of the WiZen study initiated
a debate about quality of treatment in centers certied by the German
Cancer Society. In this light the supportive role of cancer registries regard-
ing the certication process has gained new interest. e cancer registry
of Rhineland Platinate established several services for oncological centers
during past years, which meanwhile enjoy great popularity.
Conclusion: It is mandatory that oncological centers are aware of the sup-
port cancer registries provide to medical institutions in particular during
certication processes.
Disclosure Statement: e authors declare no conict of interest.
723
Spermatogonial stem cell number in boys undergoing
testicular tissue cryopreservation for fertility preservation
Vesna Bojovic1; Claudia Krallmann1; Rod Mitchell2; Sabine Kliesch1;
Stefan Schlatt1; Nina Neuhaus1
1Centre of Reproductive Medicine and Andrology, University Hospital of
Münster, Münster, Deutschland
2MRC Centre for Reproductive Health, University of Edinburgh Division of
Reproductive and Developmental Sciences, Edinburgh, United Kingdom
Background: Cryopreservation of immature human testicular tissues
(ITT) is oered by the German fertility preservation (FP) network
Androprotect to boys at risk of germ cell loss. It is unknown if sper-
matogonia, which constitute the most advanced germ cell type within
these tissues, are present in normal numbers and if patients show recov-
ery of spermatogenesis following treatment. is study therefore aimed to
determine spermatogonial numbers and to assess the reproductive health
outcome aer gonadotoxic treatment.
Methods: ITT from 160 Androprotect patients were evaluated following
immunohistochemical staining for MAGEA4. Spermatogonia per round
tubular cross section (S/T) were analyzed in ≥ 25 tubules/patient and
Z-scores were calculated. Boys ≥ 16 yrs underwent semen analysis and
treatment protocols were obtained, for calculation of Cyclophosphamide
Equivalent Dose (CED) values.
Result: Most patients (99/154) had S/T Z-scores within the normal range,
including patients with Hodgkins lymphoma (HL). In contrast, sper-
matogonial numbers were severely depleted in 23 patients, including
patients with leukemia. Semen analyses in the follow-up cohort (n=24)
revealed recovery of spermatogenesis in 10/24 patients, with the majority
(6/10) belonging to the HL group. Calculated CED values revealed that
majority of patients who received low- and medium-risk gonadotoxic
treatment (<4000; 4000-8000 mg/m2, predominantly HL patients) showed
recovery of spermatogenesis. No sperm were found in leukemia patients
who received medium to high-risk (>8000 mg/m2) treatments.
Discussion: Spermatogonial number in the normal range indicates that
ITT can be used in the future for fertility restoration approaches. is
is of relevance, as recent studies revealed dierences in the recovery of
spermatogenesis, depending on the gonadotoxicity of treatments used as
inclusion criteria for participating in FP programs.
Conclusion: Cryopreservation of ITT should be oered to boys at signif-
icant risk of germ cell loss to preserve their chance to become biological
fathers in the future.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts166
768
Processual Multidimensional Psychosocial Diagnostics
according to LINA: Development of psychosocial diagnostics
for young adults with cancer (AYA) in the LINA model project
at the Robert-Bosch-Hospital (RBH) Stuttgart, Germany
Jens Stäudle1; Thomas Stork1; Karin Strube2; Christel Idler1;
Martin Kaufmann1; Walter Erich Aulitzky1; Hans-Georg Kopp1
1Robert-Bosch-Krankenhaus, Hämatologie, Onkologie und Palliativmedizin,
Stuttgart, Deutschland
2Strube Stiftung, Stuttgart, Deutschland
Background: e LINA project at Robert-Bosch-Hospital in Stuttgart
addresses the multifaceted psychosocial challenges faced by young adults
diagnosed with cancer. is study aims to introduce the innovative pro-
cess-oriented multidimensional psychosocial diagnostic approach devel-
oped within the LINA project.
Methods: e LINA project focuses on addressing individual needs
of young cancer patients through a holistic framework encompassing
life-context orientation, integrated collaboration, empathetic engagement,
and proactive outreach. e core of this framework lies in the process-
oriented multidimensional psychosocial diagnostics, which involves con-
tinuous assessment of patients’ unique needs, resources, and challenges.
Unlike traditional static methods, this approach is dynamic, accompany-
ing patients throughout their illness journey.
Result: e diagnostic framework considers various dimensions inu-
encing patients’ well-being, including medical, legal, psychological, social,
and spiritual aspects. e collaboration between medical and psychoso-
cial teams ensures comprehensive and tailored patient care.
Discussion: e approach provides comprehensive and personalized sup-
port for young cancer patients. By integrating diverse diagnostic aspects,
it optimizes the alignment of support services with each patients distinc-
tive challenges. e continuous and dynamic nature of the diagnostics
enables adaptability to evolving patient needs.
Conclusion: e process-oriented multidimensional psychosocial diag-
nostics developed within the LINA project oer an innovative solution to
support young adults with cancer. However, further research is essential
to comprehensively evaluate the utility and eectiveness of this method-
ology. e LINA project constitutes a signicant step toward enhancing
psychosocial care for young cancer patients while highlighting the need
for ongoing assessment and renement.
Disclosure Statement: e authors declare no conict of interest.
787
Patients’ understanding of the “right not to know” in the
context of genetic testing
Paula Thomas1; Katharina Klein1,2; Ste Stegen3; Christoph Kowalski2;
Sven Asmussen4; Ute Felbor5; Dorothee Speiser6; Markus Feufel7;
Friederike Kendel1
1Charité-Universitätsmedizin Berlin, Geschlechterforschung in der Medizin
(GiM), Berlin, Deutschland
2Deutsche Krebsgesellschaft e. V., Berlin, Deutschland
3BRCA-Netzwerk e.V., Bonn, Deutschland
4Humboldt-Universität zu Berlin, Lehrstuhl für Bürgerliches Recht,
Wirtschaftsrecht und Ökonomik, Berlin, Deutschland
5Universitätsmedizin Greifswald, Institut für Humangenetik, Zentrum Familiärer
Brust- und Eierstockkrebs, Greifswald, Deutschland
6Charité-Universitätsmedizin Berlin, Zentrum Familiärer Brust- und
Eierstockkrebs, Klinik für Gynäkologie mit Brustzentrum, Berlin, Deutschland
7Technische Universität Berlin, Institut für Psychologie und Arbeitswissenschaft,
Berlin, Deutschland
Background: Learning about genetic risks allows taking action and using
prevention services whilst rejecting genetic information may serve a pro-
tective function for psychological stress and worries related to illness (1).
us, the “right not to know” has an important meaning from an ethical
and legal viewpoint. However, the signicance of the “right not to know”
for patients has not been explored in-depth.
Methods: As part of the G-BA funded project, dVP_FAM (01NVF20002), a
cross-sectional online survey was carried out with 224 participants who were
recruited via BRCA-Netzwerk e.V. e questionnaire included newly designed
and validated measuring instruments and two open-format questions. We
explored the subjective understanding of the “right not to know”. In addition, we
captured practical barriers or diculties, e.g. with insurances or in the workplace,
in relation to genetic counseling and/or testing. We summarized and structured
the responses according to Mayring (2015) and using MAXQDA soware.
Results: 81.7% of participants were female with a mean age of 48.4.
Regarding the “right not to know”, 68.8 % (n = 202) felt able to give a
personal denition. Signicant categories amongst others were “self-
determined decision” and “freedom. Moreover, participants reported job-
and family-related worries, complications with various types of insurance
and uncertainty about declaring a pathogenic variant. Nonetheless, 97.1 %
(n = 171) would choose to undergo genetic testing again.
Discussion: e results suggest that clinicians and policy makers alike
should consider patients informational needs in relation to genetic test-
ing. Uncertainty surrounding insurance contracts should be addressed.
Conclusion: e “right not to know” seems to be a construct which holds
dierent conceptions from patients’ point of view and goes far beyond
simply rejecting genetic information.
1 Deutscher Ethikrat (2013, 30 April). Die Zukun der genetischen Diagnostik –
von der Forschung in die klinische Anwendung [Stellungnahme].
Disclosure Statement: e authors declare no conict of interest.
797
Postural control in patience with chemotherapy induced
polyneuropathy (CIPN)
Henrike Fischer1; Bastian Helm2; Ulf Seifart3; Fake Faker4
1Hochschule Fresenius Hamburg - Fachbereich Gesundheit & Soziales,
Hamburg, Deutschland
2AGAPLESION EV. KRANKENHAUS MITTELHESSEN, Gießen, Deutschland
3Klinik Sonnenblick, Marburg, Deutschland
4Philipps-Universität Marburg, Marburg, Deutschland
Background: Mamma carcinoma is the most common cancer in women;
every 8th woman will fall ill with. Due to high relative survival rate of 82%
long-term therapy side eects become more relevant; like chemotherapy
induced polyneuropathy (CIPN). In 30% of cases Paclitaxel leads to CIPN.
In combination with platinum analogs 70%.
Polyneuropathy leads to sensory disorders which may cause failure in
postural control till problems in standing balance in dependence of sever-
ity of CIPN. Present pilot study is served to prove impact of CIPN on
postural sway in dierent standing positions.
Methods: 83 breast cancer patients (CIPN N=20; chemotherapy + no
PNP (CTx) N=32; no chemotherapy (CG) N=31) passed posturography
in 6 standing positions with dierent base of support and sensory condi-
tions for 30 sec each, 2nd trail, barefooted on a force plate to rate postural
control in terms of Center of Pressure. 95% ellipse area (area), average
displacement medio-lateral and anterior-posterior were analyzed.
Result: CoP diers in area in tandem stance with closed eyes (p≤0.05)
between CIPN (37.1cm2) and CG (19.2cm2). All groups dier in numbers of
breakup in this standing condition (p≤0.001; 80% in CIPN, 38% in CTx, 61%
in CG). Proportion of patients who pass tandem stance with closed eyes at 2nd
trail diers between groups (p≤0.001; 25% in CIPN, 10% in CTx, 58% in CG).
Discussion: Impairment of postural control through CIPN is visible
in postural sway just in one standing condition under raised sensory
demands. It is noticed that this standing condition also shows higher rates
of breakup and achievement at 2nd trail.
Conclusion: Bi- and monopedal stances without sensory deprivations are
not enough to evaluate impairment of postural control in patients with
CIPN or to rate degree of CIPN. Outcomes are overlayed by eects of age
and practice. Further studies controlling these inuences could be used
to rethink methods to grade and predict symptoms of CIPN, which is
important not only for quality of life, but also rating of insurances.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 167
803
RNA-seq of a cohort of cancer patients demonstrates its
capacity to reclassify uncertain variants by unveiling aberrant
splicing events
Oliver Klaas1; Thomas Keßler1; Jonas Ingermann1; Florentine Scharf1;
Caroline Heintz1; Martin Wendlandt1; Evgenia Vibe1; Taisya Volodina1;
Sabrina Angerbauer1; Tobias Wohlfrom1; Verena Steinke-Lange1,2;
Andreas Laner1; Ariane Hallermayr1,2; Morghan Lucas1;
Julia Romic-Pickl1,2; ElkeHolinski-Feder1,2
1MGZ – Medizinisch Genetisches Zentrum, München, Deutschland
2Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der
Universität München, München, Deutschland
Background: Around 5-10% of cancers are caused by hereditary tumor
syndromes. For the current state-of-the-art method of gene panel testing
via whole-exome sequencing (WES), the diagnostic yield ranges between
15-25% for these syndromes. Additional high-throughput methods are
therefore required to increase the diagnostic yield. RNA-seq can guide
the reclassication of variants of unclear signicance (VUS) and detect
previously unknown causative variants by revealing aberrant splicing at
the RNA level.
Methods: We developed a cost-ecient, high-throughput RNA-seq
approach to analyze aberrant splicing events.
Result: A total of >100 cases have so far been investigated by RNA-seq, all
of which had been previously analyzed by NGS exome sequencing with-
out revealing a clear pathogenic variant. 97 cases carried a VUS, while 4
showed no initial variants of concern. RNA-seq helped to reclassify 7 VUS
to (likely) pathogenic variants. Of these, 5 variants aected an intronic
splice site, and 2 were missense variants outside of obvious splice-relevant
regions. For one case with no initially reported variants, RNA-seq identi-
ed the use of a cryptic exon in the APC gene, guiding further analysis of
the aected intronic region.
Discussion: RNA-seq can provide clinically relevant information on VUS
and help to establish a clear diagnosis for otherwise unsolved cases, e.g.
through detection of aberrant splicing. Cases with no initial variant may
also be elucidated by targeted analysis of high-relevance genes. Overall,
we were able to reclassify ~7% of cases that could not be molecularly
solved through DNA exome sequencing. us, the diagnostic yield is sig-
nicantly improved by RNA-seq, and patient care can be optimized based
upon a conrmed diagnosis of a hereditary cancer syndrome.
Conclusion: RNA-seq is a valuable tool for reclassifying VUS and uncov-
ering pathogenic aberrations by unveiling aberrant splicing events in
patients with hereditary tumor syndromes where no DNA variant was
initially detected.
Disclosure Statement: e authors declare no conict of interest.
836
Analysis of allelic loss and aberrant splicing in capture
RNA-seq data as a supplement to DNA germline testing to
increase diagnostic yield
Florentine Scharf1; Caroline Heintz1; Thomas Keßler1; Jonas Ingermann1;
Oliver Klaas1; Martin Wendlandt1; Evgenia Vibe1; Taisya Volodina1;
Sabrina Angerbauer1; Tobias Wohlfrom1; Verena Steinke-Lange1,2;
Andreas Laner1; Ariane Hallermayr1,2; Morghan Lucas1;
Julia Romic-Pickl1,2; ElkeHolinski-Feder1,2
1MGZ - Medizinisch Genetisches Zentrum, Munich, Deutschland
2Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der
Universität München, Munich, Deutschland
Background: Hereditary tumor syndromes account for 5-10% of can-
cers. Accurate identication of causal genetic variants in aected patients is
highly important for in-patient management. e diagnostic yield of whole-
exome sequencing (WES), which is the gold standard molecular diagnostics
approach, is between 15-25% for these syndromes. To further upli diagnos-
tic rates, high-throughput functional studies, like RNA-seq, are highly desired.
ey not only help in reclassifying variants of uncertain signicance (VUS)
but also uncover pathomechanisms, such as aberrant splicing or monoallelic
expres-sion, especially in cases where no variants were initially detected.
Methods: We developed a cost-ecient high-throughput RNA-seq
approach for the analysis of RNA phenotypes where we complement
polyA mRNA capture with enrichment of 49 cancer-associated genes
from PAXgene-derived RNA samples.
Result: We achieved ultra-high coverage sequencing data of ~3,500X
mean target coverage and, on average, 80% of exons covered with >50
read depth. Based on 13 positive and 34 negative controls for allelic loss,
we could show a statistically signicant dierence based on the allele fre-
quencies of heterozygous coding variants. In almost 80% of 24 positive
controls for aberrant splicing, we detected a dierence of >20% in the PSI
(percent-spliced in) score compared to 23 negative controls.
Discussion: Our workow provides high quality RNA-Seq data, which
allows the assessment of splicing events and allelic imbalance. Our data
on the comparisons between positive and negative controls substantiate
the possibility of an automated high throughput pipeline.
Conclusion: is work represents the basis for the implementation of tar-
geted RNA-Seq in cancer diagnostics, in which we want to establish the paral-
lel analysis of Whole Exome and RNA sequencing to increase the diagnostic
yield and turnaround time for patients with hereditary tumor syndromes.
Disclosure Statement: e authors declare no conict of interest.
912
A collaboration idea between HBOC-CC and accredited breast
and gynecologic tumor centers in Berlin and Brandenburg:
quality and satisfaction
Sabrina Glagau1; Nanette Kalmbach1; Grazyna Krueger2; Nicole Zilski1;
Jens-Uwe Blohmer1; Dorothee Speiser1; Nikola Bangemann3
1FBREK-Zentrum der Charité, Klinik für Gynäkologie mit Brustzentrum Charité-
Universitätsmedizin Berlin, Berlin, Deutschland
2Klinik für Gynäkologie mit Brustzentrum Charité-Universitätsmedizin Berlin,
Berlin, Deutschland
3Brustzentrum und systemische Gynäkoonkologie, Carl-Thiem-Klinikum,
Cottbus, Deutschland
Background: e Hereditary Breast and Ovarian Cancer Center Charité
(HBOC-CC) has a unique patient population, which this study attempts
to describe, as well as potential hazards of the cooperation model.
Methods: A collaboration idea between HBOC-CC and accredited breast
and gynecologic tumor centers in Berlin and Brandenburg for patients
with breast and/or ovarian cancer has been formed since 2017. Data from
patients who underwent genetic testing at HBOC-CC between 2017 and
2021 aer being advised about it by specialized cooperating clinicians at
their primary hospital were examined. In addition, we created a comput-
erized survey that the medical professionals at the participating accredited
cancer centers may use to rate our collaboration.
Result: Between 2017 and 2021 916 patients had genetic panel analyses;
218 (23,8%) patients showed a pathogenetic variant in one of the estab-
lished core genes; among them 134 (14,6%) in BRCA1/2. 59 (27,1%)
patients had been diagnosed with TNBC, of which 44 (20,2%) had path-
ogenic germline variants in BRCA1/2. 34 Ovarian cancer patients had
pathogenic germline variants (15,6%); 8 (3,7%) patients of these were
diagnosed with breast and ovarian cancer simultaneously. A total of 16
(69,6%) of the participating physicians took part in the survey. Each
partner in a collaboration nds that it reduces their workload in organi-
zational, technical, and professional areas. Most participants see opportu-
nities for improvement in the eld of documentation.
Discussion: is cooperation model seems to help clinicians as well as
patients. Detection rates were similar to those in other settings, Survey
results showed that documentation eort should be addressed.
Conclusion: Digitalization of the cooperation model could further
increase detection rates of pathogenic germline variants using digitized
screening in the future. Furthermore, documentation could be reduced
using edocs.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts168
918
Immunocompromised patients hospitalized with COVID-19
in the US: patient characteristics and clinical outcomes across
emerging variants
Essy Mozaari1; Aastha Chandak2; Andre C. Kalil3;
Chidinma Chima-Melton4; Mel Chiang5; Eunyoung Lee1; Rikisha Gupta1;
Chen-Yu Wang5; Robert L. Gottlieb6
1Gilead Sciences, Foster City, USA
2Certara, New York, USA
3University of Nebraska Medical Center, Omaha, USA
4UCLA Health, Torrance, USA
5Gilead Sciences, Taipei, Taiwan
6Baylor Scott & White Health, Dallas, USA
Background: e COVID-19 pandemic continues to evolve with emerg-
ing variants and changing clinical practice guidelines. We describe
patient characteristics, severity, and mortality across pre-Delta, Delta and
Omicron variant of concern (VOC) periods.
Method: Using the PINC AI Healthcare Database, immunocompromised
adults (including cancer, solid organ and hematopoietic stem cell trans-
plant, hematologic malignancies, asplenia, bone marrow failure/aplastic
anemia) hospitalized with a primary diagnosis of COVID-19 were iden-
tied. We examined patient characteristics, COVID-19 disease severity
upon admission and mortality outcomes over time and by severity upon
admission.
Result: 73,013 immunocompromised adults were hospitalized with a
primary diagnosis of COVID-19. Compared to pre-Delta, immunocom-
promised patients in the Delta period required higher oxygenation levels
upon admission (20.4% vs. 16.8% high-ow oxygen/non-invasive ventila-
tion (HFO/NIV); 3.2% vs. 2.8% invasive mechanical ventilation (IMV)/
ECMO; p<0.0001) and had higher mortality rates (19.6% vs. 18.2%;
p<0.0001).
Compared to Delta, patients in the Omicron period required lower oxy-
genation levels upon admission (14.1% vs. 15.5% HFO/NIV; 25.8% vs.
30.8% low-ow oxygen (LFO); p<0.0001) and had lower mortality rates
(17.8% vs. 19.6%; p<0.0001).
Mortality rates were highest for patients aged 65+ years or requiring IMV/
ECMO upon admission, followed by HFO/NIV, those in ICU or LFO
upon admission.
Discussion: Characteristics of immunocompromised COVID-19 patients
varied considerably across VOC periods with mortality remaining high.
Conclusion: is study provides a temporal view of COVID-19 hospi-
talizations and outcomes, in the context of emerging variants, providing
critical information for clinical practice decision making for a vulnerable
cohort of immunocompromised patients.
Reference:
Mozaari E. et al. Clin. Infect. Dis. (2023): ciad460.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.:
940
Cancer and psyche - spectrum extending from inconspicuous
to syndromal adjustment disorders
Michael Brinkers1; J. Drewes1; Giselher Pfau1; Frank Meyer2
1Outpatient Clinic for Pain Therapy, Dept. of Anesthesiology and Intensive Care;
University Hospital, Magdeburg, Deutschland
2Dept. of General, Abdominal, Vascular and Transplant Surgery; University
Hospital, Magdeburg, Deutschland
Background: It is known according to Derogatis et al. that in cancer at
least 50 % of patients have no conspicuous psychological ndings; 30 % of
the patients have adjustment disorders.
In the study by Dombrowsky et al., however, it has been shown that even
below the ICD-10 diagnoses, patients show psychological symptoms.
Adjustment disorders are milder than aective disorders.
Question: Can patients have mental disorders with symptoms that have
not been considered before?
Methods: In preparation for a larger study, 39 patients were interviewed
using “Herschbachs Progression Anxiety Questionnaire” (short form) in
a pilot study.
Result: In 7 of the 12 questions, the patients had higher mean scores than
the validation sample of 1,000 patients with breast cancer.
Conclusion: Next, it is necessary to investigate what the inuencing
parameters are.
e two most obvious ones are: cancer type and gender.
1. Derogatis LR, Morrow GR, Fetting J, Penman D, Piasetsky S, Schmale
AM, Henrichs M, Carnicke CLM Jr. e prevalence if psychiatric dis-
orders among cancer patients. JAMA 1983;249:751–7.
2. Dombrowsky S, Pfau G, Kretschmar M, Meyer F, Brinkers M.
Depressionen bei somatischen Krankheiten am Beispiel der ischä-
mischen Herzkrankheit und ausgewählter Tumorerkrankungen
mit beträchtlicher Relevanz für Morbidität und Letalität. J Neurol
Neurochir Psychiatr. 2022;23:172–84.
3. Herschbach P, Dankert A, Duran-Atzunger G, Waadt S, Engst-
Hastreiter U, Keller M, Henrich G. Diagnostik von Progredienzangst.
RFB – Wissenschaliche Darstellung A2: Progerdienzangst.
Disclosure Statement: e authors declare no conict of interest.
Paediatric Cancer
109
Medication safety with oral antitumor therapeutics - What is
the need for children?
Phyllis Lensker1,2,3,4; Lisa Cuba1,2,3; Katja Schlichtig2,3; Martin F. Fromm2,3;
Frank Dörje1,3; Markus Metzler3,4
1Pharmacy Department, Erlangen University Hospital, Erlangen, Deutschland
2Institute of Experimental and Clinical Pharmacology and Toxicology,
Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
3Comprehensive Cancer Center Erlangen-EMN, Erlangen, Deutschland
4Department of Pediatric and Adolescent Medicine, Erlangen University
Hospital, Erlangen, Deutschland
Background: e therapeutic use of oral antitumor agents is continuously
increasing and is generally associated with convenient administration, both
in adult and pediatric patients. On the other hand, numerous challenges
(e.g., adherence) arise with these therapeutics. e randomized AMBORA
trial (Medication Safety With Oral Antitumor erapy1) demonstrated
highly positive outcomes (e.g., decrease of severe side eects) of an inten-
sied clinical pharmacological/pharmaceutical care program for adult
patients with oral antitumor therapy (OAT). Until now, suitable OAT care
programs for children and adolescents are lacking. We therefore aim to
introduce a comparable, tailored “youngAMBORA” care program.
Methods: A prospective survey for patients, caregivers, and clinicians was
conducted to identify special requirements of pediatric cancer patients.
Dierences in clinical characteristics (e.g., tumor entities and prescribed
OAT) were retrospectively gathered using outpatient clinic data from our
pediatric oncology department between 2017-2022. Subsequently, iden-
tied needs and characteristics of pediatric patients were compared with
the AMBORA cohort.
Results: So far, clinicians (n=32), caregivers (n=40), and patients (n=21)
completed the survey. E.g., swallowing diculties, drug handling, or side
eect reporting were named as particular challenges with oral therapy in
pediatric patients. Furthermore, we identied distinct dierences in onco-
logical entities and used OAT comparing pediatric and adult patients.
Discussion: Based on the knowledge gained in this evaluation, we will adapt
the evidence-based AMBORA program in order to address the special needs
and varying characteristics of pediatric patients. For instance, providing
appropriate information material for children (e.g., an exercise book for
swallowing) could help to improve identied challenges in the future.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 169
Conclusion: A developed demand-adapted “youngAMBORA” program
may improve medication safety in children receiving oral antitumor
therapeutics.
1Dürr et al. JCO 2021.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
363
Inhibition of intercellular communication via gap junctions
renders medulloblastoma cells more susceptible for
cytotoxictherapy
Meng-Chun Hsieh1; Ahmad Melhem1; Hannah Strobel2; Barbara E. F.
Pregler1; Lea L. Friker3; Mike-Andrew Westho2; Torsten Pietsch3;
Hartmut Vatter1; Ulrich Herrlinger4; Andreas Waha3; Anna-Laura Pottho1;
Matthias Schneider1
1Department of Neurosurgery, University Hospital Bonn, Bonn, Deutschland
2Department of Pediatrics and Adolescent Medicine, Ulm University Medical
Center, Ulm, Deutschland
3Department of Neuropathology, University Hospital Bonn, Bonn, Deutschland
4Division of Clinical Neuro-Oncology, Department of Neurology, University
Hospital Bonn, Bonn, Deutschland
Purpose: e discovery of communicative cellular networks has led to a
new understanding of brain tumor biology. Despite the growing knowl-
edge of connexin-43 (Cx43)-based gap junctions (GJ) as key drivers of
malignant intercellular connectivity in several malignant brain tum-
ors, the signicance of GJ in medulloblastoma (MB) remains largely
unknown. In the present study, we explored human MB in regard of
potential GJ-mediated intercellular communication routes and sought for
a potential therapeutic outlook.
Methods: Immunouorescence and Western blot analysis were used to
prove for Cx43-based intercellular GJ expression in group 3 and 4 MB
cell lines (MED8A and D283). Meclofenamate and Tonabersat were used
as clinically-feasible pharmacological GJ-blockers. GJ-inhibiting eects
on cell proliferation and cell death were analyzed using BrdU assay and
ow cytometry. Cellular neighborhood analysis as a surrogate readout for
intercellular morphological connectivity was performed from Real-time
imaging of ZsGreen-tagged medullobastoma cells. CRISPR/Cas9 gene
editing of Cx43 served as a validation tool of cellular eects related to GJ
inhibition.
Results: MED8A and D283 revealed positive intercellular Cx43-based GJ
expression. GJ inhibition was accompanied by antiproliferative eects and
a signicant reduction in the number of neighborhoods per cell. CRISPR/
Cas9 Cx43-knockout demonstrated a synergistic eect for lomustine-in-
duced cell death. Pharmacological GJ inhibition conrmed GJ inhibi-
tion-mediated anti-proliferative eects and profoundly rendered MB cells
more susceptible to lomustine-induced antitumoral eects.
Discussion: MB cells build on GJ as intercellular communication routes.
Further studies will be needed to explore the transcriptional linkage
between therapy failure and GJ-based connectivity.
Conclusions: Inhibition of intercellular GJ renders MB cells more suscep-
tible for lomustine-mediated cytotoxicity. GJ-targeted approaches might
constitute a novel treatment strategy for MB.
Disclosure Statement: e authors declare no conict of interest.
431
Evaluating Pre-HSCT Fitness Levels in Pediatric Cancer
Patients: A Call for Supervised Exercise Interventions
Ronja Beller1; Gabriele Gauß1; Dirk Reinhardt1; Miriam Götte2
1Zentrum für Kinder- und Jugendmedizin, Kinderheilkunde III, Westdeutsches
Tumorzentrum, Universitätsklinikum Essen, Essen, Deutschland
2Westdeutsches Tumorzentrum, Universitätsklinikum Essen, Essen, Deutschland
Background: Pediatric cancer patients preparing for allogenic hematopoi-
etic stem cell transplantation (HSCT) oen endure extensive anti-cancer
therapies. HSCTs pose high risks for life-threatening infections and trans-
plant-related complications. Maintaining physical tness is crucial. e
exploratory ANIMAL Study (DRKS ID: DRKS00019865) assesses eects
of exercise programs on immune reconstitution, motor performance and
psychological parameters, as well as transplantation related outcomes in
HSCT. Here, we present baseline data, focusing on pre-HSCT tness.
Methods: A total of n=22 pediatric patients (≥4 years) were recruited and
assessed upon admission for HSCT. Motor performance parameters were
evaluated and compared to healthy published reference data, including
static balance (1-minute static balance), sit-to-stand (leg muscular endur-
ance), isometric maximum handgrip strength (Jamar dynamometer),
isometric maximum leg extension strength (self-conducted chair with
digital force gauge, Sauter, Germany), and endurance on stationary bicy-
cle ergometer (Steep Ramp Test, SRT).
Result: All patients (5 females, 17 males; age 9.36±4.53; 73% leukemia,
10 relapses) had signicantly lower motor performance parameters com-
pared to age- and gender-specic reference values (static balance: p=.001,
sit-to-stand: p=.019, handgrip strength le: p=.000, handgrip strength
right: p=.001, leg extension strength le: p=.000, leg extension strength
right: p=.002, SRT: p=.000). No adverse events occurred during testing.
Discussion: Pre-HSCT pediatric cancer patients have notably lower t-
ness than age- and gender-specic reference values. is condition may
potentially deteriorate during hospitalization for HSCT and might aect
transplantation outcomes. Future research should explore tailored super-
vised exercise programs before HSCT.
Conclusion: Supervised exercise therapy before HSCT for pediatric
patients is critically needed and indispensable.
Disclosure Statement: e authors declare no conict of interest.
662
Assessing the physical activity of parents whose children have
cancer before and during intensive cancer treatment:
a cross-sectional study
Carolin Ohnmacht; Alexander Puzik
Zentrum für Kinder- und Jugendmedizin Universitätsklinikum Freiburg,
Freiburg, Deutschland
Background: Regular physical activity (PA) is essential for bio-psycho-so-
cial health, while reduced PA during childhood cancer treatment leads to
increased long-term side eects of aected children. Cancer and its treat-
ment determine everyday life of families and parents spend plenty of time
with their children in hospital. us, it can be assumed that the parents’ PA
is signicantly aected during their childs cancer treatment. Meanwhile,
parents have a pronounced inuence on their childrens PA-behavior. e
study aimed to investigate the parents’ PA and sitting time (ST) before and
during their childs cancer treatment.
Methods: e study took place monocentrically in the Department of
Pediatric Hematology and Oncology of the Medical Center Freiburg,
Germany. A total of 40 parents were recruited for the study in the
period from september 2021 to february 2022. PA and ST of the parents
were assessed before and during their child’s intensive oncological ther-
apy in a cross-sectional design using the International Physical Activity
Questionnaire – Short Form (IPAQ-SF). Analyses of variance were applied.
Result: e analyses included in total 40 parents (female: n = 31 (77.5%),
male: n = 9 (22.5%) between 18 and 65 years of age. e mean age was 40.1
years. e parents’ PA-levels before diagnosis were in line with reference
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts170
values. During their childrens treatment all dimensions of parents’ daily
PA and the number of MET-minutes of PA per week decreased signif-
icantly (p < 0.001). e greatest reduction in PA was identied during
inpatient stays, with a signicant increase in ST (p < 0.001).
Conclusion: is is the rst study to show that the PA of parents whose
children have cancer signicantly decreases during cancer treatment. As
parents’ PA-behavior signicantly aects their childrens during and even
aer completion of cancer treatment, future exercise programs in pediat-
ric oncology should include parents to reduce inactivity-related long-term
side eects.
Disclosure Statement: e authors declare no conict of interest.
675
The LaNCa Project - New Care Services for Long-Term
Follow-Up after Cancer in Childhood, Adolescence, and
Young Adulthood in Schleswig-Holstein
Franziska Richter1; Anne Ritz1; Ingo Menrath2; Thorsten Langer1;
Hera Becker1; Annemarie Scharnweber3; Jana Vachek3; Maike Schnoor4;
Alexander Katalinic4; Tjorven Stamer5; Jost Steinhäuser5; Nikolas Christian
Cornelius von Bubno6; Jens U. Marquardt2; Judith Gebauer2
1Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für
Kinder- und Jugendmedizin, Pädiatrische Onkologie und Hämatologie,
Lübeck, Deutschland
2Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Medizinische Klinik I,
Lübeck, Deutschland
3Universität zu Lübeck, Ratzeburger Lübeck, Deutschland
4Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Institut für
Sozialmedizin und Epidemiologie, Ratzeburger Lübeck, Deutschland
5Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Institut für
Allgemeinmedizin, Ratzeburger Lübeck, Deutschland
6Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für
Hämatologie und Onkologie, Ratzeburger Lübeck, Deutschland
Background: About 80% of children and adolescents diagnosed with can-
cer survive nowadays, but many survivors are faced with long-term eects
from the illness or treatment, with elevated risks throughout their lives.
Providing quality care for this group is crucial. Primary goal of the LaNCa
Project is enhancing long-term follow-up (LTFU) and cross- sector care.
e project includes analyses of patients’ and providers’ needs and pro-
motes guideline-based, interdisciplinary care at a university center tai-
lored to individual risk proles.
Methods: We collected patients’ and providers’ preferences and patients
care needs using guideline-based interviews and surveys. We created
comprehensive materials such as yers, a website, a doctors whitepaper,
and a patient app. Training and video consultations are oered to outpa-
tient doctors and patients. Supporting the transition to adult medicine,
workshops are designed for adolescents and parents, addressing long-
term eects, education, career, psychosocial and legal matters. ese
workshops are oered in group formats, both in-person and online.
Result: Currently, data collection is ongoing and the nal interviews are
being conducted and analyzed. e transition workshops started in July
2023. e concept and process of the study, along with initial survey and
transition workshop results, will be presented at the conference.
Discussion: e patients have a high demand for the transition work-
shops, but the structural prerequisites are not in place and need to be
established rst. Also, poor accessibility and reliability from the patient
side have been observed.
Conclusion: Children and teens who previously had cancer are a sensitive
patient group. LTFU care is vital, and transition workshops are crucial.
Both patients and providers need thorough information. Cross-sector
care and video consultations can greatly enhance care, especially in a
region like Schleswig-Holstein.
e project is supported by the Schleswig-Holstein Care Assurance Fund.
Disclosure Statement: e authors declare no conict of interest.
759
Evaluating the RIST molecular-targeted regimen in
aneuroblastomaspheroidcell culture model
Carina Kaess1; Marie Matthes1; Jonas Gross1; Rebecca Waetzig2;
Tilman Heise1; Selim Corbacioglu1; Gunhild Sommer1
1University Regensburg, Regensburg, Deutschland,
2Friedrich Alexander University, Erlangen, Deutschland
Background: Neuroblastoma is the most common extracranial solid
tumor in childhood. e outcome for patients with high-risk, relapsed,
and refractory neuroblastoma (rNB) remains dismal and novel treatment
strategies are urgently needed. RIST represents a metronomic molecular
targeted treatment strategy, combining Irinotecan and Temozolomide
with the multikinase inhibitor Dasatinib and mTOR inhibitor Rapamycin.
A prospective randomized phase II clinical trial (NCT01467986) is cur-
rently under evaluation. For preclinical drug testing the growth of cancer
cells in form of spheroids compared to monolayer cultures is of advantage
since it reproduces a wide range of avascular solid tumor characteristics,
including 3D architecture and cancer stem cell (CSC) properties.
Methods: Establishment of growth conditions for spheroids in a 96-well
format for 5 NB cell lines. Evaluation of CSC marker expression by
mRNA and protein analysis. Testing the viability of spheroids by apply-
ing luminescence-based assays. Assessment of RNA-binding protein La,
a well-known factor promoting cancer cell plasticity, by tissue microarray
analysis and patients’ data mining.
Result: Compared to monolayer cultures, spheroid cultures not only
showed increased expression of CSC markers CXCR4, NANOG and
BMI1 but also augmented phosphorylation of the NB-associated La pro-
tein (r389). Molecular targeted ‘pre-treatment’ reduced neoplastic sig-
naling, CSC marker expression and the viability of spheroids. e RIST
treatment signicantly decreased the viability of spheroids in all NB cell
lines tested.
Discussion: ese results underscore the importance of the NB spheroid
model for preclinical drug testing in an ecient high-throughput format
which can be valuable to identify more eective treatments for children
with high-risk NB in the future.
Conclusion: e RIST protocol eciently reduced the viability of NB
cells in a preclinical spheroid model despite the presence of increased CSC
properties.
Indication of source:
Kaess C, Matthes M, Gross J, Waetzig R, Heise T, Corbacioglu S, Sommer G.
Evaluating the RIST Molecular-Targeted Regimen in a ree-Dimensional
Neuroblastoma Spheroid Cell Culture Model.Cancers. 2023; 15(6):1749.
https://doi.org/10.3390/cancers15061749.
Disclosure Statement: e authors declare no conict of interest.
873
Development of novel 3D models for pediatric cancer
Alina Wallenwein1; Moni Birkhold1; Steen Gretser2; Elise Gradhand2;
Andreas Weigert3; Margarete Mijatovic3; Meike Vogler1
1Institut für Experimentelle Pädiatrische Hämatologie und Onkologie, Goethe
University, Frankfurt am Main, Deutschland
2Dr. Senckenbergisches Institut für Pathologie und Humangenetik, Goethe
University, Frankfurt am Main, Deutschland
3Institute of Biochemistry I - Pathobiochemistry, Goethe University, Frankfurt
am Main, Deutschland
Background: Rhabdomyosarcoma (RMS) is the most common malignant
so tissue cancer in children. To identify better treatment options, in vitro
models are required that faithfully recapitulate the natural microenviron-
ment in a tumor. However, most research is done in cell lines that have
adapted to growth on plastic as adherent monocultures. In this project we
develop novel 3D spheroid models of pediatric cancer that include pri-
mary patient-derived cells as well as immune and stroma cells. Also, the
eect of apoptosis inducing agents like BH3-mimetics will be investigated
and their ability to increase immune cell killing will be assessed.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 171
Methods: Histological sections from RMS tissues were examined for
immune cell inltration using multiplex imaging. Living primary cells
were obtained from routine dissections and maintained as adherent and
scaold-free spheroid cultures. Immune cells were isolated from PBMCs.
Eects of apoptosis inducing agents and immune therapy were assessed by
microscopy, FACS and CTG Assay.
Result: Preliminary data obtained from with multiplex imaging indicated
limited inltration of T- and NK-cells in RMS tissues. Mixed spheroids
including stromal cells were established using RMS cell lines. Initial
experiments indicate that addition of stromal cells does not prevent
attack by NK cells. Our collection of primary cells currently contains 23
cultures including RMS (n=5) and neuroblastoma (n=3). Treatment of
primary spheroids with BH3-mimetics indicates sensitivity to the BCL-
XL-inhibitors A1331852 and ABT-263 (Navitoclax) as well as to attack by
activated allogenic NK cells.
Discussion: Early results indicate that a combination of apoptosis-
inducing agents like BH3-mimetics and immunotherapy with NK cells
may be a promising approach for the treatment of RMS.
Conclusion: By using primary cell cultures we are currently developing
novel tools for pre-clinical assessment of novel drugs or immunotherapies.
Disclosure Statement: e authors declare no conict of interest.
Palliative Care
15
Bye Bye PIM - Deprescribing of potentially inappropriate
medications (PIMs) in palliative patients at the end of life
Felia Marie Gradetzke; Dieter Kaag; Matthias Villalobos; Veronika Odin
Thoraxklinik Heidelberg, Universitätsklinikum Heidelberg,
Heidelberg, Deutschland
Background: Palliative patients frequently experience burdensome
polypharmacy. Approaching end of life, benet of some of these drugs
may be questionable and not outweighing its possible harms. As a con-
sequence, deprescribing should be evaluated. e aim of this project was
to reduce the drug burden of palliative care (PC) patients at our 12-bed
palliative care unit, with a focus on potentially inappropriate medications
(PIMs) based on the STOPPFrail and OncPal criteria.
Methods: A team of physician, nurse, clinical pharmacist and 5th year
pharmacy student met for weekly palliative care consults (PCC). Decisions
were made based on laboratory and clinical data, OncPal and STOPPFrail
criteria.
Result: Between June 2021 and Feb. 2023, 146 patients (mean 70 y, 56%
male, main diagnosis: lung cancer) were assessed on the PC unit during
3 time periods overall spanning 24 weeks. Patients received a mean of 2
PCCs (1-8). 32 patients were excluded from analysis due to death or dis-
charge prior to PCC, resulting in 114 patients for evaluation. Among these
patients, 96 patients (84%) received at least one PIM according to men-
tioned criteria. All PIMs were successfully discontinued in 60 (62%), and
partly deprescribed in 19 (20%). 17 (18%) patients remained on all their
PIMs. At admission, patients took a mean of 7.5 drugs (range 2-18); aer
the respective last PCC, this number decreased to 5.3 drugs (range 0-15,
mean reduction 2.2 drugs per patient). e most commonly deprescribed
drugs were supplements (24%), antihypertensives (22%), gastric acid sup-
pressants (12%), and anticoagulants/antithrombotics (12%).
Discussion: In 79 of 96 patients on ≥1 PIM based on OncPal and/or
STOPPFrail criteria, PIMs could be reduced at least partially via weekly
PCCs demonstrating the successful implementation of the project. Future
research should focus on rening deprescribing criteria in STOPPFrail
and OncPal and adding further drug classes not included in the currently
available lists e.g. anticoagulants.
Conclusion: Deprescribing in PC inpatients approaching end of life was
feasible and well tolerated.
Disclosure Statement: e authors declare no conict of interest.
128
Exploratory needs assessment for the conceptualization of an
app for grieving and palliative adolescents and young adults
using the example of an online counseling service
Julia Narosch1; Sarah Salomo2; Cord Spreckelsen3
1Stiftung Hospizdienst Oldenburg, Oldenburg, Deutschland
2Universitätsklinikum Jena, Studiengang eHealth and Communication M.Sc.,
Jena, Deutschland
3Universitätsklinikum Jena, Institut für Medizinische Statistik, Informatik und
Datenwissenschaften, Jena, Deutschland
Background: In the German psychosocial and medical care system hos-
pice and palliative treatments aren’t prioritized. Especially the needs of
adolescents who are aected by loss and illness are oen overlooked in
this context. Digital applications are audience-appropriate for young peo-
ple and could address this gap within the healthcare system. e aim of
this work is to determine if there is a need for a conceptual design of an
app that specically addresses the needs of grieving and palliative adoles-
cents and young adults and which requirements such an app would have
to full.
Methods: To assess needs of users and requirements of a potential app,
two systematic focus group discussions with potential users (n=5) and
experts (n=5) as well as individual interviews (n=8) were conducted.
Using a qualitative content analysis, the collected data was systematically
evaluated and relevant needs as well as app requirements were identied.
Result: e results of the analyses show a clear need for a dedicated app
(n = 14). Identied needs were clustered in four categories: emotional,
social, manageable, informative. For both groups user experience with
the subcategories user engagement and usability was the most frequently
mentioned app requirement. Essential requirements for such an app are
satisfactory user experience and usability. erefore, user-oriented design
processes are recommended.
Discussion: Young people in grieving or palliative situations use digital
spaces by default and expect to be provided with needs-oriented support
options online. Current challenges for the implementation are the high
and unsubsidized development costs and the lack of ecacy research.
Conclusion: Institutions of hospice and palliative care should increase
their use of digital applications if they want to provide need-oriented ser-
vices for young people in the future.
Disclosure Statement: e authors declare no conict of interest.
195
The challenges of proxy reported outcome measures
exemplied by specialist palliative care
Julia Wikert1; Daniela Gesell1; Eva Lehmann-Emele1,2; Claudia Bausewein1;
Farina Hodiamont1
1Department of Palliative Medicine, LMU University Hospital, Munich,
Deutschland
2Department of Palliative Medicine, University Medical Center, Goettingen,
Deutschland
Background: Patient reported outcome measures are increasingly impor-
tant in health care. ey provide a reliable and valid way to assess patients
situations and track changes over time. Challenges remain in the proxy
use of outcome measures, especially when patients are unable to complete
self-assessments. Proxy versions address this issue and aim at patient-cen-
teredness in symptom/problem assessment. Yet sometimes, burden cannot
fully be assessed by proxies. We aim to explore ‘cannot assess’ responses in
proxy data and associations with patient characteristics.
Methods: Secondary analysis of data from the prospective, cross-sectional
COMPANION study. Proxy data collected by healthcare professionals in
three specialist palliative care settings (palliative care units, palliative care
advisory teams, specialist palliative home care). Descriptive statistics on
cannot assess’ values of the Integrated Palliative care Outcome Scale at
the beginning of care episodes, sociodemographic patient characteristics,
palliative care phase, and functional status.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts172
Results: We included 3115 episodes from 29 teams at 12 study sites
across Germany, with mean age of 72 (SD±13) years, 51% female, and
73% with malignant primary diagnosis. Full IPOS could be assessed in
1319/3115 (42%) episodes. Signicantly higher proportions of ‘can-
not assess’ responses were seen in episodes of patients with lower func-
tional status (U=787708.5,Z=-10.209,p<.001) and in the terminal phase
(H(3)=228.035,p=.000).
Discussion: Patients with low functional status and in the terminal phase
are potentially at risk of receiving incomplete assessments. Training for
professionals and further research is required to ensure holistic proxy
assessment of all patients.
Conclusion: Understanding the frequency and reasons for ‘cannot assess
responses in proxy data is essential for clinical decision-making and facil-
itating comprehensive assessment in oncology.
Funding: G-BA Innovation Fund, no.01VSF18018.
Disclosure Statement: e authors declare the following: Claudia Bausewein:
Präsidentin der Deutschen Gesellscha für Palliativmedizin, Farina Hodiamont:
Vorstandsmitglied der Deutschen Gesellscha für Palliativmedizin.
319
Improving quality of life in patients irradiated for
leptomeningeal carcinomatosis
Kalinka Radlanski1; Daniel Zips2; Dirk Böhmer1
1Charité Universitätsmedizin Berlin, Klinik für Radioonkologie und
Strahlentherapie, Campus Benjamin Franklin, Berlin, Deutschland
2Charité Universitätsmedizin Berlin, Klinik für Radioonkologie und
Strahlentherapie, Berlin, Deutschland
Background: Leptomeningeal carcinomatosis (LC) describes the diuse
metastatic spread of tumor cells in the subarachnoid cavity. It usually
occurs at the end of a disease course and is associated with dismal prog-
nosis. In most cases, therapy of LC is carried out with palliative intent
in patients with a very limited life expectancy (4-6 weeks without treat-
ment, increased to 4-6 months by radiation therapy (RT)). RT is usually
performed by whole brain RT including skull base, lamina cribrosa to 2nd
cervical vertebrum (WBRT-C2) in a single dose fraction of 3 Gray (Gy) up
to a total dose of 30 Gy. erapy planning and follow-up are based on the
assumption that, due to the limited life expectancy, tumor-related disor-
ders take precedence over therapy-associated late eects. However, xeros-
tomia is a radiation-associated side eect known to have a particularly
strong impact on the quality of life (QoL) that has not yet been considered
while carrying out RT of LC.
Methods: Retrospective data analysis of 40 patients who received radio-
therapy for their LC in our department from January 2018 to August
2023. Primary tumor, RT type, time period, and time period between last
RT and time of death/life status at survey were analyzed. In addition, the
mean dose to Gll. parotideae was compared.
Result: 32 patients were suitable for evaluation. e mean time of survival
aer the last day of RT in these patients was 7,6 months (range 4 years-0
days). Six patients showed an exceptionally long course since the last day
of their RT ranging from 1.2 years until even 4 years. On average, the le
Gl. parotidea received 13.35 Gy (range 24.1-2.7 Gy), the right Gl. parot-
idea 17.6 Gy (range 21.3-11.4 Gy).
Conclusion: Patients with LC live on average for 7,6 months aer comple-
tion of RT, and sometimes even considerably longer. During this period,
signicant side eects may develop, which can impair QoL. Currently,
WBRT-C2 does not spare Gll. parotideae by default although this is feasi-
ble in modern radiotherapy. We recommend considering this reasonable
measure to avoid unnecessary impairment of QoL in the palliative setting.
Disclosure Statement: e authors declare no conict of interest.
354
Attitudes of physicians towards standardized palliative care
assessments in oncological inpatient settings
Julia Wikert; Claudia Bausewein; Farina Hodiamont
Department of Palliative Medicine, LMU University Hospital, Munich,
Deutschland
Background: Palliative care needs are complex and their timely identica-
tion is crucial, though challenging. e German Cancer Society demands
the implementation of standardized screening tools for palliative care
needs to facilitate early and appropriate support of burdened patients.
However, the perspective of physicians on oncological hospital wards
towards such standardized tools remains unclear. We aimed to explore
attitudes of oncologists in Germany towards standardized palliative care
assessments.
Methods: Qualitative study throughout Germany with semi-structured
expert interviews and content analysis according to Mayring of verbatim
interview transcripts.
Results: Data collection commenced in 07/23 (so far nine interviews con-
ducted) and will presumably terminate in 10/23. Preliminary results show
that the degree of standardization in the evaluation of palliative care needs
varies notably across oncological wards. Even though oncologists recog-
nize benets of systematic assessments, the evaluation of palliative care
needs is mostly inconsistent and frequently rests on subjective impres-
sions. Concerns preventing the increased use of standardized assessments
include perceived knowledge gaps and time constraints.
Discussion: Oncologists recognize the value of comprehensive assess-
ment including palliative care needs. Implementation of standardized pal-
liative care assessments on oncological wards should include training and
support for professionals, intending to use the respective tools.
Conclusion: e evaluation of palliative care needs on oncological wards
benets from a systematic approach, calling for the use of standardized
assessments. Analysis will be completed by 12/23.
Literature: Mayring, P. (2020). Qualitative content analysis: theoretical
foundation, basic procedures and soware solution. Klagenfurt.
Funding: Verein zur Förderung von Wissenscha und Forschung an der
Medizinischen Fakultät der LMU München.
Disclosure Statement: e authors declare the following: Claudia Bausewein:
Präsidentin der Deutschen Gesellscha für Palliativmedizin; Farina Hodiamont:
Vorstandsmitglied der Deutschen Gesellscha für Palliativmedizin.
385
Screening for specialist palliative care need in oncology:
literature review and toolbox
C. Roch1; Susanne Gahr2; Astrid Schnabel3; Michael Müller4; Paul Sölder4;
Mitra Tewes5; Evelyn Müller4; AG Palliativmedizin Netzwerk Onkologische
Spitzenzentren6
1Interdisciplinary Center for Palliative Medicine & Comprehensive Cancer Center
Mainfranken, University Hospital Würzburg, Würzburg, Deutschland
2Department of Palliative Medicine & Comprehensive Cancer Center, CCC
Erlangen – EMN, University Hospital Erlangen, Friedrich-Alexander-University
Erlangen-Nürnberg, Erlangen, Deutschland
3Leipzig University Cancer Center, Leipzig, Deutschland
4Department of Palliative Medicine, Medical Center- University of Freiburg,
Faculty of Medicine, University of Freiburg, Freiburg, Deutschland
5Department of Palliative Medicine, West German Cancer Center, University
Hospital Essen, University of Duisburg-Essen, Essen, Deutschland
6Koordinationsstelle der AG Palliativmedizin im CCC-Netzwerk, Erlangen,
Deutschland
Background: e identication of patients with incurable cancer requir-
ing specialist palliative care (SPC) has been the subject of research for
many years. In this context, many dierent screening tools have been
developed. Although the objectives are similar, each tool has dierent
characteristics, strengths, and weaknesses. erefore, we aimed to acquire
an overview on screening tools for SPC need suggested for use in oncol-
ogy patients and provide summaries of the literature regarding the most
relevant screening tools.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 173
Methods: Systematic literature review to identify publications on screen-
ing tools in Medline (2012 – 05/2022) and CINAHL (2012-05/2022);
results were screened by two reviewers. Publications reporting on screen-
ing tool development, validation and application were included, if the
screening tool aimed at identifying need for SPC.
Result: In 660 publications, 20 sta-assessed screening tools and ve
patient-reported outcome measures have been suggested for use in
oncology patients. Six of them are generic, 12 indication- and seven
entity-specic. e proposed screening tools include disease-, treatment-
and care-related criteria, as well as patient and family needs. Overall, most
relevant information for choice of screening tools – diagnostic accuracy
to identify SPC need, cut-os based on validation studies or interrater-
reliability in proxy assessment – are reported only for some selected
tools. For the most relevant tools – three PROMs and three sta-assessed
screening tools - that might be considered for use in Germany, summaries
on the state of research regarding aspects of validation and use in practice
are provided in a toolbox.
Discussion: e choice and application of a screening tool for SPC need
should be done with an upfront understanding of the strengths and limi-
tations of each tool.
Conclusion: e toolbox can assist in the selection of an appropriate
screening instrument.
Disclosure Statement: e authors declare the following: Susanne Gahr wird als
Mitarbeiterin der koordinationsstelle der AG Palliativmedizin im CCC-Netzwerk
durch die Deutsche Krebshilfe nanziell unterstützt.
406
Supporting informal caregivers of dying persons: Does an
educational program meet the needs of multiprofessional
hospital ward teams? A qualitative study using participant
observation
Carlotta Jorzick; Karin Oechsle; Carsten Bokemeyer; Anneke Ullrich
Palliative Care Unit, Department of Oncology, Hematology and BMT, University
Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
Purpose: Health care professionals (HCPs) on hospital wards are oen
insecure how to deal with informal caregivers (ICs) of dying persons.
A90-120 min educational program on “Supporting informal caregivers of
dying persons in hospitals” was developed to empower HCPs. e focus is
on successful communication with ICs and HCPs’ self-reection. e pur-
pose of this pilot study was to observe and describe the extent to which the
educational program meets the training needs of HCPs on non- palliative
care wards.
Methods: is qualitative research was based on participant observation
of educational programs with three multiprofessional teams of a univer-
sity hospital (HCPs n=41). Participant observation was conducted using
a priori dened criteria and was recorded in detailed notes. e records
were analyzed using qualitative content analysis.
Results: Behavior and contributions of HCPs conrmed the educational
program in content and elaboration. Despite observed psychological bur-
dens and aggravating factors for the HCPs in context of supporting ICs,
participants showed a great will to improve IC support. Immediate eects
of the educational program were observed on individual and team level,
including validation of the HCPs behavior, identication of shared val-
ues and responsibilities as well as clinical implications for IC support. e
variety of teaching methods proved to be eective, as they addressed dif-
ferent learning needs and led among others to inquiries, increased atten-
tion, and self-reection. e learning impact was supported by the direct
connection to the HCPs emotions and experiences. However, room for
improvement was also identied in terms of shortening factual informa-
tion, rephrasing and including new topics.
Discussion: Topics and teaching methods chosen for the educational
program corresponded to the training needs of hospital ward teams in
dealing with ICs.
Conclusion: Hospital ward teams have a great interest in the adequate
and compassionate care of ICs. HCPs can even benet from a condensed
educational program.
Disclosure Statement: e authors declare no conict of interest.
557
Palliative-specic stressors for health care professionals on
non-palliative care wards and comparison with palliative
carewards
Nikolas Oubaid1; Viola Milke1; Aneta Schieferdecker1; Holger Schulz2;
Sukhvir Kaur3; Sophie Meesters3; Kerstin Kremeike3; Christin Leminski4;
Raymond Voltz3,5,6; Carsten Bokemeyer1; Karin Oechsle1
1Department of Oncology, Hematology and BMT, Palliative Care Unit, University
Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2Department of Medical Psychology, University Medical Center
Hamburg-Eppendorf, Hamburg, Deutschland
3Department of Palliative Medicine, Faculty of Medicine and University Hospital,
University of Cologne, Köln, Deutschland
4Chair of Quality Development and Evaluation in Rehabilitation, Institute for
Medical Sociology, Health Services Research and Rehabilitation Science, Faculty
of Human Sciences & Faculty of Medicine and University Hospital Cologne,
Köln, Deutschland
5Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO
ABCD), Faculty of Medicine and University Hospital, University of Cologne, Köln,
Deutschland
6Center for Health Services Research (ZVFK), Faculty of Medicine and University
Hospital, University of Cologne, Köln, Deutschland
Purpose: In Germany, most people die in hospitals on non-palliative care
wards (n-PCW). e aim of this study was to identify palliative-specic
stressors perceived by health care professionals (HCP) on n-PCWs, and
compare them with stressors perceived on PCWs. Additionally, data of
general wards (GW) and intensive care units (ICU) were compared.
Methods: Primary data comprised an online sta survey (n=201) on 10
selected n-PCWs of two university hospitals (6 ICUs, n=126; 4 GWs=75).
We assessed 11 palliative-specic stressors (stressors were dichotomized).
Stress score was calculated as an index ranging from 11 (not stressed at
all) to 44 (heavily stressed). Results were compared to secondary data of a
survey on 95 PCWs in Germany (n=873).1
Results: Top 3 stressors on n-PCWs are demand on care for dying patients
(41.3%), unexpected death (38.8%), and special relationship with infor-
mal caregivers (ICs) (36.3%). Top 3 stressors on PCWs are demand on
care for dying patients (51%), special relationship with patient (47.2%)
and accumulation of deaths (42.6%)1. HCPs on ICUs score signicantly
higher in total stress (M=22.5, SD=4.7) than on GWs (M=20.6, SD=4.7,
p=.005). Top 3 stressors on ICUs are demand on care for dying patients
(49.2%), special relationship with ICs (40.5%) and unexpected death
(38.9%). Top 3 stressors on GWs are unexpected death (38.7%), special
relationship with the patient and ICs (each 29.3%).
Discussion: e relationship with the ICs is perceived stressful on
n-PCWs, but not as much on PCWs. HCPs on ICUs are more stressed
than on GWs and dier in the stress intensity over specic stressors. HCPs
on GWs report that the special relationships with the patients and ICs is
perceived as equally stressful.
Conclusion: N-PCWs could benet from measures regarding ICs.
Specically on ICUs, palliative care advisory teams should be included
earlier due to HCPs high stress of demand on care for dying patients.
Indication of source:
1 Müller, M et al. Wie viel Tod verträgt das Team? Schmerz 23, 600–608 (2009).
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts174
565
Dealing with systemic therapies at the end of life
in cancer patients
Henrik Schulte-Hürmann1; Julius Hettich2; Dirk Arnold3; Georgia Schilling3
1Semmelweis University of Medicine, Asklepios Campus Hamburg, Hamburg,
Deutschland
2Akershus Universitetssykehus, Nordbyhagen, Norwegen
3Asklepios Tumorzentrum Hamburg, AK Altona, Hamburg, Deutschland
Background: e decision to continue systemic therapy at the end of life
must be weighed against the potential negative impact of treatment-re-
lated toxicities. e aim of this study was to investigate the patterns of use
and initiation of systemic therapy at the end of life.
Methods: is retrospective, monocentric study consecutively included
all patients with a cancer diagnosis who died in the palliative care unit of
the Asklepios Tumorzentrum Hamburg, AK Altona between 11/2018 and
07/2023. e interval between the last administration of systemic therapy
and the end of life (30 days, 3 months, >3 months) as well as initiation of
the last line of therapy before death were investigated. Dierences in the
administration of chemo-, immuno-, and targeted therapy were of interest.
Result: 357 patients with hematologic malignancies (14%) or solid malig-
nant tumors (86%) were included. 34% of patients received no further sys-
temic therapy. 40% received chemo-, 7% targeted- and 6% immunotherapy
as their nal therapy. An additional 13% received a combination of these
drug classes at the end of life. Initiation of a new line of therapy within the
last 3 months of life was documented in 31% of all patients; in 10%, the new
treatment was initiated only one month before death. 52% received sys-
temic therapy in the last 3 months of life, with 35% continuing it until the
nal 30 days. ere was no signicant dierence between the types of ther-
apy regardless of their last use before the end of life, duration, or initiation.
Discussion: In 31% of treated patients, a new line of therapy was started
within the last 3 months of life. is may be due to a lack of tools to
improve patient selection or a lack of interdisciplinary discussion in
tumor boards. Observational studies and registries are warranted to iden-
tify and evaluate such criteria.
Conclusion: Our study showed that 52% of patients already under pal-
liative care received systemic therapy in the last 3 months of life. ese
results indicate that we need tools to be more considerate and selective
with the administration of systemic therapies at the end of life.
Disclosure Statement: e authors declare no conict of interest.
569
Psychological burden and supportive care needs of informal
caregivers in specialist palliative care: study protocol for a
multicenter prospective longitudinal study
Clara Haufschild1; Anne Daubmann2; Karin Oechsle1; Holger Schulz3;
Antonia Zapf2; Carsten Bokemeyer1; Anneke Ullrich1
1Palliative Care Unit, Department of Oncology, Hematology and BMT, University
Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2Institute of Medical Biometry and Epidemiology, University Medical Center
Hamburg-Eppendorf, Hamburg, Deutschland
3Department of Medical Psychology, University Medical Center Hamburg-
Eppendorf, Hamburg, Deutschland
Purpose: is abstract introduces a study protocol investigating psycho-
logical burden and supportive care needs of informal caregivers (ICs)
of patients at the beginning of and in the trajectory of specialist pal-
liative care. is 3-year study pursues two objectives: Firstly, to weekly
assess ICs’ psychological burden and supportive care needs, focusing
on possible course types and inuencing factors. Secondly, to validate a
newly developed short multidimensional screening instrument for ICs
(HAM-CAREPAL-8).
Methods: is research employs a multicenter prospective longitudinal
design. A sample of ICs (N=689) will be recruited from 16 in- and outpa-
tient specialist palliative care facilities across Germany. Data will be col-
lected using the HAM-CAREPAL-8 and a set of validated and standardized
questionnaires at the initiation of specialist palliative care and weekly for
up to 10 weeks. To minimize the burden of repeated questioning on ICs, a
design with planned missing values is implemented for the follow-up ques-
tionnaires (Planned Missing Data Design). e analysis of the longitudinal
data will be performed using Growth Mixture Models (GMM).
Results: e conference contribution will outline the study protocol and
will include reections on the ongoing research process, particularly
focusing on strategies used to overcome barriers well known in research
with vulnerable populations.
Discussion: is well powered study is expected to yield insights in course
types and inuencing factors of psychological burden and supportive care
needs of ICs during specialist palliative care. If the HAM-CAREPAL-8
proves valid, a tool would be available that would make it possible to clas-
sify ICs in clinical daily practice with regard to dierent risk proles of
multidimensional burden.
Conclusion: With successful implementation, we expect that the nd-
ings will have signicant implications for palliative care providers and
policy-makers helping them recognize and address the ICs’ unique chal-
lenges in daily cancer care. e study is funded by the German Cancer
Aid (70115093).
Disclosure Statement: e authors declare no conict of interest.
572
Improving the dying situation on non-palliative care wards:
Evaluation of the participants’ perspectives on a bottom-up
approach
Viola Milke1; Nikolas Oubaid1; Aneta Schieferdecker1; Anneke Ullrich1;
Holger Schulz2; Sukhvir Kaur3; Sophie Meesters3; Kerstin Kremeike3;
Christin Leminski4; Raymond Voltz3,5,6; Carsten Bokemeyer1; Karin Oechsle1
1Department of Oncology, Hematology and BMT, Palliative Care Unit, University
Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2Department of Medical Psychology, University Medical Center Hamburg-
Eppendorf, Hamburg, Deutschland
3Department of Palliative Medicine, Faculty of Medicine and University Hospital,
University of Cologne, Köln, Deutschland
4Chair of Quality Development and Evaluation in Rehabilitation, Institute for
Medical Sociology, Health Services Research and Rehabilitation Science, Faculty
of Human Sciences & Faculty of Medicine and University Hospital Cologne,
Köln, Deutschland
5Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO
ABCD), Faculty of Medicine and University Hospital, University of Cologne, Köln,
Deutschland
6Center for Health Services Research (ZVFK), Faculty of Medicine and University
Hospital, University of Cologne, Köln, Deutschland
Purpose: In the “Dying in Hospitals - Optimization of Care in the Dying
Phase” project (Funded by the “Innovations-Fond”), multi-professional
working groups (WGs) of health care professionals (HCPs) were estab-
lished on ten non-specialist palliative care wards at two university hos-
pitals. In these researcher-supported WGs, wards-specic measures to
optimize care in the dying phase were developed by using a bottom-up
approach. e experience and satisfaction of the HPCs with the WGs and
the implementation of the measures was evaluated.
Methods: Aer the WG process, an online survey was sent to all HCPs
who participated in the WGs in January 2023. e survey consisted of 17
closed, self-developed questions on a 3-point Likert scale rating the HCPs’
satisfaction with the content, outcomes of the WGs and the implemen-
tation on the wards. We used descriptive statistics to analyze the results.
Results: A total of 69 WG meetings (mean: 6.9, range: 5-12) were held
with 3-6 HPCs in mean per meeting and a duration of 1-1.5h. Of 78 eligi-
ble HCPs, 48 responded to the survey (63%): 52% nurses, 23% physicians
and 25% psychosocial HPCs. e majority (16 of 17 items) of questions
were rated positively (range: 55-91%). e most valued aspect was the
opportunity to contribute own opinions/topics in the WG process (91%).
Most HCPs would participate again in such WGs (77%) and would rec-
ommend HCPs of other wards to develop own interventions to improve
care in the dying phase (80%). Satisfaction with the developed measures
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 175
for their wards was 66%. However, 55% reported that implementing the
measures at the ward level had worked well.
Discussion: e results show that implementing a bottom-up approach to
the development of measures by HPCs is possible and positively rated, but
may also face implementation challenges.
Conclusion: e positive ratings and satisfaction with the researcher-
supported WG process indicate the use of a bottom-up strategy to develop
interventions for care in the dying phase on non-specialist palliative
carewards.
Disclosure Statement: e authors declare no conict of interest.
637
Study protocol of a longitudinal mixed-methods study
exploring psychological burden, quality of life and support
needs of informal caregivers during non-specialist palliative
care in a Comprehensive Cancer Center (CCC)
Lena Hagedorn; Anneke Ullrich; Tabea Theißen; Carsten Bokemeyer;
Karin Oechsle
Palliative Care Unit, Department of Oncology, Hematology and BMT, University
Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
Purpose: Informal caregivers (ICs) are crucial for the well-being of
advanced cancer patients. However, their needs are not always recognized
in daily oncology practice and there is no strategy for early identication
of highly burdened ICs during non-specialist palliative care as part of
cancer care. e aim of this mixed-methods longitudinal cohort study is
to determine the psychological burden, quality of life (QoL) and support
needs of ICs within cancer care in a CCC.
Methods: A quantitative study part involving N≥260 adult ICs collects
data using self-report questionnaires on psychological burden, QoL and
support needs within 8 weeks aer the patient’s initial diagnosis of incur-
able cancer, follow-ups during cancer treatment every 3 months over a
maximum of 3 years or until the patient‘s death, as well as 3-6 months
aer death (if occurred). Questionnaires include validated and reliable
instruments. Data is analyzed using descriptive and inferential statis-
tics. Simultaneous, a qualitative study part is conducted consisting of
semi-structured interviews with - depending on data saturation - about
n=20 ICs each at all three time points. Grounded theory is used to analyze
qualitative data.
Results: e data collection phase of this 5-year study with a recruitment
phase of 36 months was initiated in April 2023 including cooperation
partners from the CCC network. Qualitative analysis takes place itera-
tively while conducting the interviews.
Discussion: is study will be one of the rst to reveal systematic data on
psychological burden, QoL and support needs of ICs during cancer care
(non-specialist palliative care) in CCCs during the course of advanced
cancer - from rst diagnosis until bereavement. Furthermore, the longitu-
dinal design will provide reference of changes over time when patients are
treated for advanced cancer in a CCC.
Conclusion: Detailed knowledge about psychological burden, QoL and
support needs of ICs of advanced cancer patients could be relevant for
improving cancer care in future. e study is funded by the Hamburg
Cancer Society.
Disclosure Statement: e authors declare no conict of interest.
670
Electronic PROM in home-based palliative care in Germany:
feasibility and perceived value
Katerina Hriskova1; Isabel Burner-Fritsch1; Stefanie Kolmhuber1;
Christina Ramsenthaler2; Claudia Bausewein1
1Klinik und Poliklinik für Palliativmedizin, LMU Klinikum, Ludwig-Maximilians-
Universität München, München, Deutschland
2ZHAW Gesundheit, Winterthur, Schweiz
Purpose: To pilot the use of eIPOS (electronic version of the Integrated
Palliative Outcome Scale) in Specialised Palliative Home Care (SPHC); to
explore patients’ and health care professionals (HCP) views on it.
Methods: Quasi-experimental mixed methods design - intervention
group: patients completed eIPOS on their laptop/tablet repeatedly. i)
IPOS-values were transferred directly into the digital patient record, ii)
qualitative interviews (patients), focus groups (HCPs). Descriptive and
framework analyses. A symptom/problem was dened as prevalent when
patients reported at least “moderate” burden.
Result: 82 SPHC-patients used eIPOS (22.7% recruitment rate, 87% with
incurable cancer, mean age 68.5 y; 49% female) and submitted overall 470
eIPOS forms (average 5.7/pat.; range 0-15). Missing values in submitted
eIPOS were low (<5%). Most prevalent symptoms: “lack of energy,” “poor
mobility,” and “family burden. Using eIPOS leads patients to reection on
their own situation and gives them a feeling of empowerment. However,
some described it as stressful due to confrontation with their own situ-
ation/ symptom burden. HCPs indicated that eIPOS supports holistic
assessment, detection of unrecognised symptom burden, and improved
communication.
Discussion: Unlike traditional data collection (text-based documenta-
tion), information from electronic patient-reported outcome measure-
ment (ePROM) is computable, immediately available, can be continuously
updated and easily tracked longitudinally. As SPHC is for palliative patients
with complex symptom burden, only few could use eIPOS. Nevertheless,
ePROM supports care by identifying undetected symptoms, detecting
changes, and improving communication between HCP and patients.
is was also conrmed in our study, especially in the detection of psy-
chosocial symptom burden.
Conclusion: HCPs see potential of eIPOS in palliative home care, patients
describe predominantly positive eects. However, independent use is
challenging for many SPHC patients. erefore, informal caregivers
should be involved in its use.
Disclosure Statement: e authors declare no conict of interest.
733
Standardized training for recruitment of informal caregivers
in palliative care research
Anneke Ullrich; Carsten Bokemeyer; Karin Oechsle
Palliative Care Unit, Department of Oncology, Hematology and BMT, University
Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
Purpose: Many palliative care studies fail to recruit adequately and on
schedule. erefore, strategies to support recruitment of informal caregiv-
ers (ICs) of patients with life-limiting illness for research are needed. We
discuss the development, piloting, and preliminary assessment of a novel
training to improve researchers’ positive attitudes and communication
skills in recruiting ICs in palliative care research.
Methods: We developed a 90 min evidence-based, standardized training
guided by adult learning principles. e program was implemented by the
palliative care research group specialized in IC research in a university
hospital. Preliminary assessment comprised detailed notes of the trainings
including oral feedback from the trainees.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts176
Results: e training content includes 1) ethical considerations, 2) evi-
dence on ICs’ motives to participate in research, 3) potential barriers for
recruitment focusing on IC factors, “gatekeeping”, and ethical concerns, 4)
key procedures of recruiting, and 5) communication with ICs. Teaching
methods used include theoretical input, reective learning, and short case
vignettes helping to apply theory to practice. To enhance successful com-
munication, standardized wording is provided (e.g. regarding thoughtful
messaging to make research relevant). Until now, 21 researchers with var-
ying experience (doctoral candidates, student assistants, psychosocial and
clinical researchers) participated in three trainings. Trainees reported to
feel more positive and condent about IC recruitment. e mix of research
experience and professional background among trainees enhanced the
learning. Trainees’ feedback included the usefulness of practicing through
role-plays and a pocket-sized laminated card with key information and
standardized wording.
Discussion: Based on the assessments, the training materials will be fur-
ther developed, re-piloted, and manualized.
Conclusion: A carefully craed recruitment may be eective. Our experi-
ence with piloting the standardized training indicates the benets of such
an approach.
Disclosure Statement: e authors declare no conict of interest.
737
Development of an educational program for multiprofessional
hospital ward teams to improve informal caregiver support
during patients‘ last days of life
Anneke Ullrich; Carlotta Jorzick; Carsten Bokemeyer; Karin Oechsle
Palliative Care Unit, Department of Oncology, Hematology and BMT, University
Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
Purpose: e aim of the study is developing, piloting, and assessing an
educational program for healthcare professionals (HCPs) to improve their
knowledge, attitudes, and communication skills in caring for informal
caregivers (ICs) of patients dying in hospitals.
Methods: is conference contribution describes the development of the
90-120 min program “Supporting informal caregivers of dying persons
in hospitals” tailored to the specic learning needs of multiprofessional
teams on non-palliative care wards. e program was developed for being
implemented in hospitals by specialist palliative care services (SPCS).
Results: e eory of Planned Behavior and adult learning principles,
emphasizing reective and interactive learning, guided the development.
e components of the program were identied by literature review,
an expert panel of palliative care and psychosocial specialists, and key
informants (e.g. leading nurses). Key features include the implementation
as a multiprofessional, ward-based, in-service intervention provided by
SPCS. e contents aimed to improve HCPs’ competencies in the fol-
lowing broad areas: 1) attitudes towards caring for ICs confronted with
death, 2) informing ICs about the dying process, 3) exploring ICs’ intense
emotions and supporting them, 4) managing challenging communica-
tion situations, and 5) personal awareness and self-care. Selected teaching
methods include theoretical input, group discussions, reective learning,
and short case vignettes. Trainees are provided with a pocket-sized lami-
nated card, helping them to apply their knowledge to practice.
Discussion: is very condensed, evidence-based educational program
addresses main elements of IC care during patients’ last days of life. If the
pilot implementation and assessment proves to be successful, a prelimi-
nary program would be available to enhance the competencies of HCPs
on non-palliative care wards with regard to IC care.
Conclusion: We anticipate that the program will positively inuence
planned behavior and will empower HCPs to better support ICs.
Disclosure Statement: e authors declare no conict of interest.
738
Social support experience during bereavement: Does
expected versus unexpected loss make a dierence?
Anneke Ullrich1; Birgit Wul2; Laura Schäfsmeier1; Jan Herzog1;
Carsten Bokemeyer1; Klaus Püschel2; Karin Oechsle1
1Palliative Care Unit, Department of Oncology, Hematology and BMT, University
Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf,
Hamburg, Deutschland
Purpose: Although social support is supposed to be helpful, negative
interactions with others may impede its positive eects during bereave-
ment. is cross-sectional study investigated the positive and nega-
tive experiences of social support among bereaved next-of-kin (BNK)
6 months to 6 years aer an expected or unexpected loss of a beloved
person.
Methods: A total of N=377 BNK (n=205 bereaved by expected deaths
during palliative care, n=172 by sudden out-of-hospital deaths) com-
pleted questionnaires on social support (ISSS-8; scales: Positive Support
and Detrimental Interactions, both ranging from 0=lowest to 16=high-
est) and psychological burden. Tests for mean dierences were used to
compare the social support experience aer expected vs. unexpected loss.
Predictors of the social support experience were examined by multiple
regression analysis, including the expectancy of death.
Results: An average of 3.1 years post loss, the mean Positive Support score
was 10.8 of 16 (SD=3.8) and the mean Detrimental Support score was 2.5
of 16 (SD=2.9). About 36% of BNK (n=128) experienced no detrimen-
tal interactions (score: 0) and 10% (n=37) reported the highest level of
positive support (score: 16). We did not nd any dierences in the social
support experiences between BNK aected by expected vs. unexpected
loss. Predictors of higher levels of positive support were a non-spousal
relationship to the deceased (ß=.211, ß<.001) and lower depressive symp-
toms (ß=-.350, p<.001). Higher levels of detrimental interactions were
predicted by elevated symptoms of post-traumatic stress disorder (PTSD;
ß=.245, p=.002) and complicated grief (ß=.298, p<.001).
Discussion: Detrimental interactions stemming from social networks are
a relevant issue in BNK. However, they occur independently of the expec-
tancy of death, but are associated with bereavement-related psychological
burden.
Conclusion: Bereavement support should address negative social interac-
tions, particularly in BNK aected by symptoms of complicated grief and
PTSD, regardless of whether the loss was expected or not.
Disclosure Statement: e authors declare no conict of interest.
833
Far advanced cancer (FAC) patients’ point-of-view on
decision-making and end-of-life interaction
Isabel Kruschel1; Cordula Gebel1; Katsiaryna Laryionava2;
Rebecca Boekels2; Marc Cinci2; Eva Winkler2; Ulrich Wedding1
1Department of Internal Medicine II (Palliative Care), University of Jena, Jena,
Deutschland
2Department of Medical Oncology, National Center for Tumor Diseases (NCT),
Programme for Ethics and Patient-oriented Care in Oncology; Heidelberg
University Hospital, Heidelberg, Deutschland
Background: In patients with far advanced cancer (FAC) decisions on
anti-cancer treatment and/or initiation of palliative care are frequent and
challenging balancing medical information with patients’ values and pref-
erences. We assess patients’ perception of decisional conict, participation
in decision-making and their impact on patient-physician interaction in
FAC. Additionally, we explore how sociodemographic data inuence deci-
sional conict and end-of-life discussions.
Methods: Using data of the rst measurement point from a study on par-
ticipatory decision-making, FAC patients completed a multidimensional
questionnaire aer consultation with the oncologist following imaging
for treatment choice. Self- reported sociodemographic data and validated
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 177
scales measuring decisional conict, decision-making participation, life
quality (QL) vs length (LL) preferences and patient-physician interaction
satisfaction were analyzed descriptively and inferentially.
Result: 56 patients with FAC participated. Most consultations (89%)
yielded decisions about treatment and the majority in continuing
anti-cancer therapy. From the patients’ point of view, the decisional con-
ict was low (mean 27.6, SD 19.1), Patients’ involvement in decision-mak-
ing is negatively correlated with decisional conict (r=0.54, p=0.00) and
positively correlated with satisfaction of patient-physician interaction
(r=0.70, p=0.00). OL and LL showed no correlation. Sociodemographic
data showed no notable decision-making inuence in our analysis.
Discussion: ere is a lack of analysis regarding criteria relevant to FAC
patients in decision-making scenarios. Findings highlight decisional con-
icts’ role in patient participation and satisfaction with patient-physician
interaction.
Conclusion: Awareness of these simple measured values could improve
decision-making by inuencing the style and content of patient-physician
interaction.
Disclosure Statement: e authors declare no conict of interest.
842
Creating and implementing a decision aid for far advanced
cancer patients in an outpatient setting: Perspectives of
health care professionals and valuable lessons learned
Rebecca Boekels1; Katsiaryna Laryionava1; Jan Schildmann2;
Michel Wensing3; Ulrich Wedding4; Bastian Surmann5; Katja Mehlis1;
Cordula Gebel4; Marc Cinci1; Katja Krug3; Eva Winkler1
1Nationales Centrum für Tumorerkrankungen – NCT, Heidelberg, Deutschland
2Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
3Universitätsklinikum Heidelberg - Medizinische Fakultät, Heidelberg,
Deutschland
4Klinik für Innere Medizin II - Palliativmedizin, Jena, Deutschland
5Health Economics and Health Care Management, Bielefeld, Deutschland
Background: Decision aids (DAs) can be a valuable tool for patients with
far advanced cancer in complex decision-making situations. Building on
the ndings of a DA implementation study, this analysis aims to shed light
on barriers for implementation from the perspective of health care pro-
viders, especially oncologists, and to identify problem areas that require
special attention.
Methods: is study is based on two data sets from related research proj-
ects, consisting of n=29 semi-structured interviews with oncologists and
three focus groups with members of various health professions. In addi-
tion, n=5 semi-structured interviews with oncologists following the use of
the DA in the doctor-patient interview were included. e data thus col-
lected were analyzed for content and supplemented with insights gained
during the design and implementation of the DA.
Result: Two central themes emerged from our ndings: 1) Standardizing
the use of DA conicts with adapting it to the individual needs of patients.
2) Factors that contribute to the successful implementation of DA, includ-
ing senior physician support, palliative care training, and supportive
organisational conditions.
Discussion: e study highlights divergent opinions on the value of stan-
dardizing the use of DA in cancer end-of-life care. Some participants
advocate standardized guidelines to ensure consistent use of DA, while
others emphasize the need for adaptability to individual patient contexts.
A two-part generic DA is presented to balance standardization and indi-
vidual patient needs.
Conclusion: Among the hurdles to be overcome before practical applica-
tion, lack of support from senior doctors and lack of training stand out as
they can be specically addressed. e use of a two-part DA for patients
with far advanced cancer in oncology represents an innovative approach to
resolving the conict between individualization and standardization as it is
applicable to all cancer types while oering the opportunity to be individu-
ally tailored to the patients needs and readiness to discuss end-of-life issues.
Disclosure Statement: e authors declare no conict of interest.
896
Caring together for advanced breast cancer: Digital
networking and support for caring relatives of people
suering from breast cancer in the last phase of life
Sara Marquard
Universität Osnabrück, Osnabrück, Deutschland
Background: Relatives of people suering from metastatic breast cancer
have a high need for support in terms of accompanying the person with
the disease as well as their own psychological, social and organizational
needs. Digitally support is hardly available and suer from qualitative
deciencies.
Methods: Based on a scoping review on the needs of family members, a
standardized online survey as well as individual interviews with family
members were conducted. e standardized data were analyzed descrip-
tively. e analysis of the qualitative data was carried out content-analyti-
cally. e results were analyzed together with a digital agency and various
experts in order to derive target group-specic conclusions for the devel-
opment of a digitally supported socio-technical support system.
Result: Relatives feel burdened in the support of women suering from
metastatic breast cancer. New responsibilities and burdens arise for the
persons living in the same home. is involves new or changed roles as
well as relationship problems. Family members have unmet needs, mostly
information decits. Specically, there is uncertainty about the near and
distant future and a high need for information about disease-specic top-
ics, social aspects and relationship aspects. Stabilizing factors include sup-
port networks that are perceived as both present and digital.
Discussion: A specic app must provide support services for family
members and relatives (information, counseling, case management), take
into account specic phases of the process (diagnosis, progression of the
disease, dying process, survival aer death) and provide specic topics
(knowledge of care, relationships/interaction, body experience, help mix,
work and care in uncertainty), depending on the experience of stress.
Conclusion: For the subsequent implementation study, this means
developing an app based on the identied technical, conceptual and con-
tent requirements that is able to provide adequate, evidence-based and
low-threshold support to residents and members.
Funding: e project was funded by the BMBF.
Disclosure Statement: e authors declare no conict of interest.
Primary and Secondary Prevention
190
Does an overall unhealthy life-style reduce the ecacy of
a brief alcohol intervention? Findings from a randomized
controlled trial in general hospital patients
Filipa Krolo-Wicovsky1; Sophie Baumann2; Anika Tiede1; Gallus Bischof3;
Beate Gaertner4; Ulrich John5; Jennis Freyer-Adam1
1Universitätsmedizin Greifswald, Institut für Medizinische Psychologie,
Greifswald, Deutschland
2Universitätsmedizin Greifswald, Institut für Community Medicine, Abteilung
Methoden der Community Medicine, Greifswald, Deutschland
3Universität zu Lübeck, Klinik für Psychiatrie und Psychotherapie, Lübeck,
Deutschland
4Robert-Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
5Universitätsmedizin Greifswald, Institut für Community Medicine, Abteilung für
Prävenstionsforschung und Sozialmedizin, Greifswald, Deutschland
Background: At-risk alcohol use, a leading risk factor for cancer devel-
opment and mortality, is oen accompanied by other modiable behav-
ioural cancer risk factors (CRFs), i.e. tobacco smoking, physical inactivity
or overweight. Brief alcohol interventions can reduce alcohol use and
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts178
improve health. Little is known on whether their ecacy diers by the
participants’ overall lifestyle. We investigated if the number of CRFs mod-
erates in-person and computer-based brief alcohol intervention ecacy in
general hospital patients with at-risk alcohol use.
Methods: As part of a German Cancer Aid funded randomized controlled
trial, 961 general hospital patients with at-risk alcohol use aged 18-64
years were allocated to in-person counselling, computer-generated indi-
vidual feedback and assessment only. Both intervention groups included
contacts at baseline, 1 and 3 months later. Aer 6, 12, 18 and 24 months,
self-reported alcohol use per day was assessed as outcome. e CRF sum
score was tested as a moderator of alcohol use using likelihood ratio test
and a latent growth curve model.
Result: Overall, CRF sum score did not moderate ecacy signicantly
(p = .179). However, participants with 1 more CRF (n = 275) reduced
alcohol use more strongly aer computer-based intervention compared
to assessment only at month 6 (p = .032). ose with all 4 CRFs (n = 174)
reduced alcohol use more strongly aer computer-based intervention up
to month 24 (ps <.004) and aer in-person intervention up to month 18
(ps <.044) compared to assessment only.
Discussion: Both computer-based and in-person BAI were especially
ecacious in reducing alcohol use among participants with all 4 behav-
ioural CRFs. One helpful behaviour change mechanism may have been
the highly individualized, strictly theory-driven and motivation tailored
intervention.
Conclusion: Proactive, theory-driven, and highly individualized BAI,
regardless of delivery mode, has the potential of being particularly eec-
tive in those most in need of intervention, i.e. for general hospital patients
with the unhealthiest lifestyle.
Disclosure Statement: e authors declare no conict of interest.
283
iSCREEN – a digital questionnaire regarding familial breast
and ovarian cancer
Nora Amirpour-Mehrhof1; Katharina Klein2,3; Christina Mangum4;
Benedikt Lotz1; Shirin Saadat Sarmadi1; Stephen Schüürhuis5;
Simone Wesselmann3; Ste Stegen1,6; Jenny Katharina Wagner1;
Jens-Uwe Blohmer1; Friederike Kendel2; Markus Feufel4; Dorothee Speiser1
1Charité – Universitätsmedizin Berlin, Zentrum Familiärer Brust- und
Eierstockkrebs, Klinik für Gynäkologie mit Brustzentrum, Berlin, Deutschland
2Charité – Universitätsmedizin Berlin, Department of Gender in Medicine, Berlin,
Deutschland
3Deutsche Krebsgesellschaft e.V., Bereich Zertizierung, Berlin, Deutschland
4Technische Universität Berlin, Department of Psychology and Ergonomics (IPA),
Division of Ergonomics, Berlin, Deutschland
5Charité – Universitätsmedizin Berlin, Institute of Biometry and Clinical
Epidemiology, Berlin, Deutschland
6BRCA-Netzwerk e.V., Hilfe bei familiären Krebserkrankungen, Bonn,
Deutschland
Background: Around one third of breast cancer patients have a famil-
ial cancer burden. Advances in screening programs, genetic analysis, and
risk-reducing surgery enhance the ability to prevent hereditary breast, and
ovarian cancer. To benet from all these opportunities, a familial cancer
burden must be identied as early as possible. is identication process
relies on the use of a checklist provided by the German Cancer Society
(GCS, Deutsche Krebsgesellscha e. V.). e completion and interpre-
tation of this checklist is reserved for medical professionals. e active
involvement of the patients themselves in a digital approach can simplify
the process. e study aimed to assess iSCREENs accuracy in comparison
to the personal interviews by the medical professionals, as well as its usa-
bility and psychological impact.
Methods: As part of the GBA-funded project dVP_FAM (01NVF20002),
iSCREEN was developed transforming the GCS-checklist into a digital
patient questionnaire. e evaluation of the data is based on the GCS-
algorithm and the results are sent digitally to the physician with the
patients’ consent. An exploratory study with upstream in-silico analysis
was executed. First, 200 pedigrees were evaluated using iSCREEN and
the results were compared with the GCS-checklist to verify accuracy.
Aerwards, 160 patients lled out iSCREEN, followed by a personal inter-
view. e usability analysis focused on factors such as completion time,
comprehensibility, and preferred assessment method.
Result: e study revealed that iSCREEN identied all patients with
a familial cancer burden. Study participants reported the questions in
iSCREEN to be easily understandable and had no problem completing
the questionnaire. Additionally, the majority expressed interest in using
iSCREEN in the future. No negative psychological eect was observed.
Discussion & Conclusion: e digital questionnaire iSCREEN seems
to be well suited to identify individuals with a familial cancer burden in
gynecological practices. A CE mark will be obtained for regular use of
iSCREEN in standard care.
Disclosure Statement: e authors declare no conict of interest.
594
OnkoRiskNET: A multicenter, interdisciplinary,
telemedicine-based model to improve care for patients
with a genetic tumor risk syndrome
Johanna Tecklenburg1; Beate Vajen1; Caroline Scholz1;
Christian Landgraf1; Paula Memenga2; Eva Baumann2; Sarah Wöling3;
Judith Böthig3; Evelin Schröck3,4,5,6,7; Clara Dubois8; Sonja Gscheidle8;
Matthias Arnold8; Anke Katharina Bergmann1; Schlegelberger Brigitte1
1Department of Human Genetics, Hannover Medical School, Hannover,
Deutschland
2Department of Journalism and Communication Research, Hanover University
of Music, Drama and Media, Hannover, Deutschland
3Institute for Human Genetics, University Hospital Carl Gustav Carus Dresden,
Dresden, Deutschland
4ERN GENTURIS, Hereditary Cancer Syndrome Center Dresden, Dresden,
Deutschland
5National Center for Tumor Diseases Dresden (NCT/UCC), Germany: German
Cancer Research Cen-ter (DKFZ), Heidelberg, Deutschland
6Faculty of Medicine and University Hospital Carl Gustav Carus at TU Dresden,
German Cancer Consortium (DKTK), Dresden, Deutschland
7Max Planck Institute of Molecular Cell Biology and Genetics, Dresden,
Deutschland
8inav – Private Institute for Applied Health Services Research GmbH, Berlin,
Deutschland
Background: Genetic tumor risk syndromes account for at least 10% of
newly diagnosed cases of cancer in Germany each year. e diagnosis
of a genetic tumor risk syndrome enables personalized therapy and pre-
vention, as well as the identication of other aected family members.
However, they are oen overlooked. OnkoRiskNET aims to bridge this
care gap.
Methods: e study is led by the Department of Human Genetics at
Hannover Medical School and will be running up to 2025. 26 oncology
practices are participating in the project forming a network between
practicing oncologists and human genetics specialists in Lower Saxony
and Saxony. Patients will receive routine care or the new care approach
with structured care pathways, case management, and telemedical genetic
counseling. Randomization is conducted at the practice level using a
stepped wedge design. With a mixed-methods approach we will assess:
(1) Uptake of human genetic counseling; (2) Patient satisfaction and psy-
chological distress; (3) Factors inuencing the acceptance and experience
of telemedical genetic counseling; (4) Satisfaction of physicians with the
care model; (5) Cost-eectiveness.
Result: Within the rst 16 months, the study has enrolled 377 out of 756
planned oncology index patients - due to the stepped wedge design 291 in
the control group and 82 in the intervention group. Preliminary analyses
reveal that the uptake of genetic counseling was 46% in the control group
compared to 96% in the intervention group.
Discussion: Our preliminary results suggest that the new model of care
leads to an improved uptake of genetic counseling and testing in patients
with a suspected genetic tumor risk syndrome.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 179
Conclusion: Initial results show that the new care model facilitates access
to genetic diagnostics, helps to overcome barriers in identifying patients
with a genetic tumor risk syndrome and thus improves the care of these
patients.
Disclosure Statement: e authors declare no conict of interest. OnkoRiskNET
is funded by a grant from the Federal Joint Committee of the Federal Republic of
Germany.
699
Improving students knowledge about cancer
Winja Weber; Karen Herold; Julia Geulen; Karin Greulich-Bode;
Susanne Weg-Remers
Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
Background: In order to eectively prevent cancer, it is important to
educate adolescents about relevant cancer risk factors and possibilities of
prevention. is requires eective interventions – particularly in school
settings, as this may compensate for social disadvantages. us, we have
developed scientically based teaching materials, among them materials
on carcinogenesis, and on risk factors, including human papillomavirus
(HPV). e latter is particularly important, as vaccination can eectively
prevent HPV-induced cancers at young age. e aim of this study was to
investigate whether teachers’ use of the materials in class could eectively
improve students’ knowledge.
Methods: We conducted an intervention study in a pretest-posttest design
with students in grades 6 to 13. Knowledge about the respective content
of the teaching materials was measured using multiple-choice questions.
We used paper-pencil questionnaires both once before and twice (imme-
diately aerwards and four weeks later) aer a teacher had a lesson based
on these materials. In addition, we collected socio-demographic data and
a perception of the materials (e.g. not interesting – interesting). A total of
N = 85 students participated in all three survey waves for carcinogenesis
and N = 119 for HPV.
Result: e students evaluated both materials positively, perceiving the
topics as particularly interesting and important. Repeated-measures anal-
yses of variance showed that both materials signicantly improved the
knowledge of the students. Post-hoc comparisons with Bonferroni cor-
rection showed signicant increases in knowledge from the rst to the
second as well as to the third measurement time points.
Discussion/Conclusion: e use of scientically based teaching materials
helps to improve childrens and young peoples knowledge of carcinogene-
sis, and cancer prevention by HPV vaccination eectively and sustainably.
is may increase vaccination rate and contribute to the prevention of
cancer in the long term.
Disclosure Statement: e authors declare no conict of interest.
843
Can brief alcohol interventions among general hospital
patients produce benecial spill-over eects on other
cancer-risk related behaviors?
Jennis Freyer-Adam1,2; Filipa Krolo-Wicovsky1,2; Anika Tiede1,2;
Sophie Baumann3; Gallus Bischof4; Beate Gaertner5; Ulrich John2,6
1Institute for Medical Psychology, University Medicine Greifswald, Greifswald,
Deutschland
2German Center for Cardiovascular Research, Greifswald, Deutschland
3Department for Methods in Community Medicine, Institute of Community
Medicine, University Medicine Greifswald, Greifswald, Deutschland
4Department of Psychiatry and Psychotherapy, Medical University of Lübeck,
Lübeck, Deutschland
5Department of Epidemiology and Health Monitoring, Robert Koch Institute
Berlin, Berlin, Deutschland
6Department of Prevention Research and Social Medicine, Institute of
Community Medicine, University Medicine Greifswald, Greifswald, Deutschland
Background: About half of the general adult population report multiple
cancer-risk related behaviors. E.g. among adults who drink alcohol at risk,
about 90% also report tobacco smoking, insucient physical inactivity
and/ or overweight. Little is known about potential spill-over eects of
behavior change interventions that address alcohol use on other can-
cer-risk related behaviors. e aim was to investigate whether eective
computer-based and in-person brief alcohol interventions may reduce
various cancer-risk related behaviors among general hospital patients
with at-risk alcohol use.
Methods: rough systematic screening, 961 18-64 year old patients with
non-dependent at-risk alcohol use were identied (75% male, 53% tobacco
smokers); and allocated to three study groups: 1) computer-based written
feedback, 2) in-person motivational interviewing based counseling and 3)
treatment as usual. Both alcohol interventions were tailored to the indi-
vidual motivational stage of change and were delivered directly on the
ward; and 1 and 3 months later. Secondary outcomes were self-reported
tobacco smoking, servings of vegetable and fruit per day, physical activity
and body mass index aer 6, 12, 18 and 24 months. Adjusted latent growth
models were calculated. Funding was provided by the German Cancer Aid
(108376, 109737, 110676, 110543, 111346, 70114206, 70115012).
Result: Aer 2 years, and compared to assessment only, the in-person
intervention resulted in benecial eects on body mass index (p<0.05),
and by trend on physical activity (p=0.05). e computer-based interven-
tion resulted in reduced smoking among smokers aer 6 months (p<0.05)
and by trend in lower gain of body mass index aer 24 months (p=0.05).
Discussion: Proactive, theory-driven, highly individualized in-person
and computer-based brief alcohol interventions may also reduce other
single cancer-risk related behaviors.
Conclusion: For long-term and comprehensive cancer-risk related behav-
ior change, interventions addressing all co-occurring cancer-risk related
behaviors may be needed.
Disclosure Statement: e authors declare no conict of interest.
855
Vitamin in prevention of cancer: ction or truth
Andre Rotmann
Privatpraxis Dr. Rotmann, Frankfurt am Main, Deutschland
Background: Cancer, is an unavoidable risk in life that aects nearly every
second individual in industrialized countries. However, a low vitaminD
status is a risk in particular for cancers of colon, prostate, and breast.
Vitamin D intake could reduce cancer mortality in the population by
12percent - provided the vitamin is taken daily. is was the result of an
evaluation of 14 studies of the highest quality conducted at the German
Cancer Research Center with a total of almost 105,000 participants. is
oral presentation want to present this data and show how this easy tool
could be integrated in the complementary oncology.e aim of this sys-
tematic review and meta-analysis of randomized controlled trials (RCTs)
was to summarize and evaluate the eects of vitamin D3 supplementation
(VID3S) on cancer outcome.
Methods: I searched PubMed, Web of Science and Cochrane databases.
Result: When all 14 studies were pooled, no statistically signicant results
emerged. However, when the studies were divided according to whether
vitamin D3 was taken daily in a low dose* or in higher doses administered
at longer intervals, a large dierence was seen. In the four studies with the
infrequent hogher doses, there was no eect on cancer mortality. In contrast,
in the summary of the ten studies with daily dosing, the researchers deter-
mined a statistically signicant twelve percent reduction in cancer mortality.
Conclusion: is work underlines the great potential of vitamin D3
administration in the prevention of cancer deaths. Regular intake at low
doses* is associated with almost negligible risk and very low cost.” e
Check of the Vitamin D Levels is easy and makeable. e Integration in
Daily work is mandatory.
Source: Kuznia S. et al.: Ecacy of vitamin D3 supplementation on cancer mor-
tality: Systematic review and individual patient data meta-analysis of randomised
controlled trials. Ageing Res Rev. 2023, DOI: 10.1016/j.arr.2023.101923.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts180
859
Cluster Randomized Trial: Sun Protection Intervention
Clever in Sun and Shade for Preschools’—Eectiveness and
Dissemination
Nadja Knauthe1; Vera Fieber1; Melanie Glausch1; Eckhard W. Breitbart2;
Martin Bornhäuser1,3; Friederike Stölzel4
1National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Deutschland
2Arbeitsgemeinschaft Dermatologische Prävention (ADP) e. V., Buxtehude,
Deutschland
3Universitätsklinikum Carl Gustav Carus Dresden, Medizinische Klinik und
Poliklinik I, Dresden, Deutschland
4University Cancer Center Schleswig-Holstein (UCCSH), Kiel, Deutschland
Background: Skin cancer is one of the most common types of cancer
and UV radiation is one of the main risk factors. erefore, sun protec-
tion, especially in childhood, is strongly recommended. We examined
the eectiveness of the ‘Clever in Sun and Shade for Preschools’ program
(CLEVER) in promoting sun protection behavior among preschool sta
(trial registration: DRKS00023468) and describe its dissemination.
Methods: Within a cluster randomized trial with 24 preschools (n=273
sta members) stating a high need for sun protection measures, an
educational workshop for preschool sta and a project kit with materials
applicable in preschool groups was provided.
Result: Sta members of preschools taking part in CLEVER report signif-
icantly stronger sun protection behavior to avoid the sun (eect size [ES]
0.70, 95% condence interval [CI] 0.04 0.71, p<0.05) and less perceived
impediments to avoid the sun (ES −0.56, CI −0.82 −0.17, p<0.01) aer 12
months as well as higher self-ecacy to avoid the sun (ES 1.09, CI 0.39
1.07, p<0.001) and to use sunscreen (ES 0.71, CI 0.03 0.88, p<0.05) aer
1 month. Compared to the control group, there was no signicant eect
on sunscreen use and further psychosocial outcomes. e eectiveness of
CLEVER may be underrated due to a high drop-out rate.
Conclusion: Within three years, an enhanced free-of-charge program kit,
including a media-based workshop and materials, had reached over 4000
preschools, i.e., 7.1% of all daycare centers in Germany. e results show
that CLEVER can strengthen sun protection, oer high-quality informa-
tion at low cost, and is easily disseminable.
Indication of source:
Seidel N, Fieber V, Breitbart EW, Bornhäuser M, Stölzel F. Cluster Randomized
Trial: Sun Protection Intervention ‘Clever in Sun and Shade for Preschools’-
Eectiveness and Dissemination. Children (Basel). 2021 Jul 28;8(8):651.
doi: 10.3390/children8080651. PMID: 34438542; PMCID: PMC8391804.
Disclosure Statement: e authors declare no conict of interest.
920
Increased UV burden in daycare centers through climate
change
Vera Fieber1; Friederike Stölzel2; Melanie Glausch1; Eckhard W. Breitbart3;
Nadja Knauthe1
1National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Deutschland
2University Cancer Center Schleswig-Holstein (UCCSH), Kiel, Deutschland
3Arbeitsgemeinschaft Dermatologische Prävention (ADP) e. V., Buxtehude,
Deutschland
Background: Health consequences of climate change are increasingly in
the focus of research. In educational settings, professionals are challenged
to protect themselves and the children entrusted to them from negative
eects. Children are particularly vulnerable to health impacts of climate
change, such as skin damage caused by increased UV exposure.
Methods: e authors conducted a nationwide online survey in
November/December 2022 to determine the extent to which educational
professionals perceive health stresses due to climate change in recent
years. Participants were recruited using convenience sampling.
Result: N=4879 educators participated in the survey; n=3791 records
(median age=40-49 years; 93% female) met the criteria for completeness.
Heat and UV radiation were found to be particularly stressful: 70.9% and
43.1%, respectively, felt strongly exposed to these factors, followed by
allergens, extreme weather events, psychological stress, infections, and air
pollutants. A moderate percentage reported heat protection (65.4%) and
UV protection (76.8%) measures. More than 40% would like to have more
free information material and further training.
Discussion: e high number of participants indicates the relevance
of health-related climate change impacts in early childhood education
institutions and the need for various prevention measures, especially to
reduce exposure to heat and UV radiation. e sample was representative
for preschool educators in Germany in terms of gender and supporting
institutions, but not in terms of age and federal state.
Conclusion: Increasing awareness of the impacts of climate change oers
opportunities for the prevention of UV-related skin damage and skin can-
cer. For example, the free program “Clever in Sonne und Schatten für Kitas
(Clever in Sun and Shade for Preschools) can help institutions raise awareness
among educators, parents and children about appropriate UV protection.
Disclosure Statement: e authors declare no conict of interest.
Psychooncology
13
Exploring the requirements for preparing, delivering and
following-up breaking bad news conversations in pediatric
oncology: results of a participatory group delphi
Theresia Krieger; Kerstin Dittmer; Isabel Hamm; Frank Vitinius
Universität zu Köln, Köln, Deutschland
Background: In pediatric oncology, breaking bad news (BBN) is perceived
as particularly challenging. Failure to address the specic needs of pediat-
ric patients/children and their relatives can negatively impact on both the
BBN recipients and providers (e.g., physicians). Pediatric-specic BBN
support tools lack in Germany. e project OKRA – Orientation Compass
for BBN in the pediatric oncology – aims to develop a tool to prepare,
guide and further support BBN providers. We present the rst phase of a
two-phase project, funded by the German Leukemia Research Aid.
Methods: Fourteen organizations were actively engaged in this PGD.
Aer exploring the emerging themes around the categories preparing,
delivering, and following up a BBN the OKRA theses were formulated.
Result: ORKAs rst phase consists of a Participatory Group Delphi
(PGD). Multiperspective knowledge was systematically generated through
interviews, focus group discussions and surveys. Qualitative thematic
analyses are applied, supported by MAXQDA. Four groups participated:
(1) experts from own experiences (organizations representatives on behalf
of aected children and their parents), (2) BBN providers from pediatric
oncological teams and representatives of national professional societies,
(3) psychosocial supporters (e.g., counselors), and (4) health system
researchers. Following ve steps, this PGD culminated in the formulation
of theses for the high-level management of BBN.
Discussion: A systematically designed tool for BBN preparation, delivery,
and follow-up in pediatric oncology is of outstanding interest. For provid-
ers, it may reduce emotional distress and lead to improved quality of care.
For recipients, a well performed BBN may impact on their ability to cope
with the disease and increase psychosocial well-being.
Conclusion: Exploring the detailed requirements from multiple perspec-
tives leads to a comprehensive understanding of the issues to be addressed
around the BBN. e PGD results in pediatric oncology-specic theses
that build the foundation for the BBN guiding tool OKRA.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 181
77
A Portray of Available Information on Cancer-related Fatigue
on German Healthcare Institutions’ Websites: Quality,
Credibility, Usability, and Readability of Information
Anna S. Wagner1; Marlena Milzer2,3; Karen Steindorf 2; Senta Kiermeier1;
Martina Schmidt2; Imad Maatouk1
1Universitätsklinikum Würzburg, Medizinische Klinik II für Innere Medizin,
Abteilung Psychosomatik, Psychotherapie, Psychoonkologie, Würzburg,
Deutschland
2Deutsche Krebsforschungszentrum und Nationales Tumor Zentrum,
Heidelberg, Deutschland
3Universität Heidelberg, Heidelberg, Deutschland
Background: Recent surveys revealed that cancer patients feel poorly
informed about cancer-related fatigue (CRF). Considering the idea of
patient empowerment by providing information this study aimed to
portray available information on CRF on German healthcare institution
websites.
Methods: Based on general website quality criteria we developed a website
rating tool comprising 18 items. Descriptive analyses, Kruskal Wallis tests
and corresponding post-hoc tests comparing rating sum scores between
institution groups were performed.
Results: Websites of 281 systematically compiled German cancer centers,
hospitals, and other healthcare institutions regularly treating cancer
patients were included in the rating. CRF was introduced on 21.9% and
detailed information was provided on 27.9% of the websites. Information
material was linked on 9.2% and treatment oers were provided on 21.6%
of the websites. Rating sum scores diered between institution groups
(p < .001) with Comprehensive Cancer Centers scoring signicantly
higher than the others. Contents were overall dicult to read.
Discussion: Institutional websites could serve as trusted information
sources for patients aected by CRF. However, information on CRF and
references to appropriate treatment oers were not included on most of
the German healthcare institutions’ websites. If provided, information was
mostly not as easily understandable as the American Medical Association
recommends for patient-centred text.
Conclusion: Provision of information on institutional websites was sparse
with CRF being addressed on less than half of them. Healthcare institu-
tions in cancer care may need to improve their websites so that they at least
contain an introduction of CRF and refer patients further to external web-
pages or information booklets with already existing, high- quality infor-
mation. Naming contact persons may help linking patients to providers.
Disclosure Statement: e authors declare no conict of interest.
127
Barriers to an eective patient-physician communication
about cancer-related fatigue
Marlena Milzer1,2,3; Anna S. Wagner4; Martina Schmidt1,2; Imad Maatouk4;
Silke Hermann5; Senta Kiermeier4; Karen Steindorf1,2
1Division of Physical Activity, Prevention and Cancer, German Cancer Research
Center (DKFZ) Heidelberg, Heidelberg, Deutschland
2National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership
between DKFZ and University Medical Center Heidelberg, Heidelberg,
Deutschland
3Medical Faculty, University of Heidelberg, Heidelberg, Deutschland
4Section of Psychosomatic Medicine, Psychotherapy and Psychooncology,
Department of Internal Medicine II, Julius-Maximilian-University, Wuerzburg,
Deutschland
5Epidemiological Cancer Registry of Baden-Württemberg, German Cancer
Research Center (DKFZ), Heidelberg, Deutschland
Background: Cancer-related fatigue is a frequent symptom impair-
ing patients’ quality of life and daily functioning. However, it is oen
unrecognized and represents a common unmet need for supportive care.
In this study, we investigated cancer patients’ views on the patient-physi-
cian communication about fatigue.
Methods: e multimodal LIFT project included a survey of 1,179 cancer
patients ve months aer diagnosis. Patients were systematically recruited
through the Cancer Registry of Baden-Wuerttemberg. e survey included
questions on fatigue management, communication barriers, and perceived
quality of patient-physician communication about fatigue. Descriptive sta-
tistics and logistic regression analyses were used for analysis.
Results: Fiy-six percent of the sample was female, and the most common
cancer types were breast (26%) and colorectal cancer (16%). Half of the
patients were never asked about exhaustion by their physicians, 74% were
not informed about fatigue, and only 13% received a systematic fatigue
screening. Two-thirds of the patients perceived communication barriers,
such as not knowing who to turn to (39%), time constraints (31%), the belief
that physicians consider fatigue unimportant (26%) and the fear of being
perceived as weak (22%). A large number of patients rated the quality of
patient-physician communication about fatigue as unsatisfactory.
Discussion: Due to various structural, patient-related and physician-
related barriers fatigue is oen not addressed between patients and physi-
cians. When a conversation about fatigue does occur, patients experience
the quality of communication as insucient.
Conclusion: Improving patient-physician communication about fatigue
is a necessary step to overcome shortcomings in fatigue management.
erefore, physicians should regularly address fatigue, conduct screen-
ings, and provide information, as suggested in guidelines. A reective
communication style might further encourage patients to seek a dialogue
about fatigue and raise their questions.
Disclosure Statement: e authors declare no conict of interest.
170
Eects of Chemotherapy and Radiotherapy in Mothers
withGynecologic Tumors on the Mother-Child Relationship
Theresa Engel1; Antonia Rabe2; Achim Wöckel1; Elisabeth Jentschke2
1University Hospital Würzburg (UKW), Department of Gynecology, Würzburg,
Deutschland
2University Hospital Würzburg (UKW), Department of Psychooncology,
Würzburg, Deutschland
Background: e prevalence of psychological distress in mothers with
gynecologic tumors is high. e aim of this study is to identify these wom-
ens needs and possible entry points for support by interdisciplinary sta.
Methods: We interviewed women with gynecological tumors, who
received therapy and had underage children in a semi-structured manner
and performed a qualitative content analysis (Kuckartz). e following
hypotheses were tested: 1) e burden of chemo- and/or radiotherapy in
mothers with gynecological tumors has an impact on the mother-child
relationship (MCR), which can be both negative and positive. 2.1)
Support regarding children from clinical sta has a positive eect on both
the MCR and the mother’s quality of life (QoL). 2.2) Mothers who are
more open with their children about their illness have a higher QoL.
Results: e category-based evaluation of 29 interviews showed six central
categories: experience of the diagnosis, mothering aer diagnosis, MCR,
communication, environment and psychooncological care. Most women
indicated a change in the MCR, most of them a positive one. Of those
women who received psychooncological care a majority noticed a positive
change in the MCR. On one hand, patients with a lower QoL received
psycho-oncological care more frequently and communicated more openly
with their children – compared to mothers with a higher QoL. On the
other hand, the group of women with higher QoL communicated slightly
more open than not in their own group.
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Discussion/Conclusion: e women noted general decits in care, par-
ticularly regarding the challenges of mothers with cancer, such as com-
munication, childcare, and running the household. Although a simple
generalization of the statements falls short, our study can help raise aware-
ness of the specic stress-related burdens of mothers with cancer among
clinical sta to reduce some of their emotional stress. ere seems to be
a high correlation between QoL and openness about the disease which
needs further investigation.
Disclosure Statement: e authors declare no conict of interest.
178
Online music therapy group intervention for patients
receiving cancer therapy - intervention development and
feasibility testing
Miriam Grapp; Charlotte Flock; Till Johannes Bugaj
Univeristätsklinik Heidelberg, Abteilung für Allgemeine Innere Medizin und
Psychosomatik, Heidelberg, Deutschland
Background: Various reviews show signicant positive eects of music
therapy interventions in terms of improvement of anxiety, depressive
symptoms, and pain. Music therapy group interventions are of particular
importance, as they have not only the music therapy-specic eects, but
also the special group therapy eect factors.
Methods: We developed supportive and resource-oriented music therapy
group intervention for patients under tumor therapy. e unique charac-
teristic of this intervention is that it is oered online and video-based due
to the situational particularities caused by the corona pandemic as well as
due to the limited physical mobility of many patients under tumor ther-
apy. e focus of the intervention is on receptive music therapy, i.e. active
listening to music. e contents of the music therapy group intervention
include: (1) using music as a resource, (2) learning about ones own musi-
cal biography (3) dealing with fears, worries and other stressful feelings,
and (4) music-induced relaxation and mindfulness.
Result: Currently, this innovative group concept is being evaluated in a
pilot study, especially with regard to the feasibility and acceptance of the
online intervention. e group concept and rst results of the pilot study
will be presented at the congress.
Discussion: While on an international perspective music therapy care in
the eld of oncological acute therapy is well established, there are still few
comparable interventions in Germany. One possible reason for this could
be that in Germany music therapy is anchored above all in oncological
rehabilitation and in the treatment of highly palliative patients, but has so
far hardly found its way into the acute sector due to the oen challenging
conditions.
Conclusion: In case of proven feasibility and acceptability the online
music therapy group intervention could be an innovative care option,
especially for physically impaired patients for whom face-to-face services
are too burdensome.
Disclosure Statement: e authors declare no conict of interest.
185
Therapeutic Alliance in Psycho-Oncology – A Systematic
Review
Charlotte Flock; Miriam Grapp; Rahel Oldsen;
Hans-Christoph Friederich; Till Johannes Bugaj
Universitätsklinikum Heidelberg, Klinik für Allgemeine Innere Medizin und
Psychosomatik, Heidelberg, Deutschland
Purpose: erapeutic Alliance (TA) has been established as a crucial suc-
cess factor of psychotherapy. Despite compelling hints towards a signi-
cant role of TA in psycho-oncology, seemingly little research exists. us,
an overview is aimed to be reached by systematically identifying (1) key
characteristics of TA in psycho-oncological care and (2) concepts related
to TA in psycho-oncological care settings.
Methods: PRISMA-reporting guidelines were followed and the review
was preregistered (PROSPERO). PubMed, PsycInfo, and Web of Science
were systematically searched for empirical studies looking upon adult
cancer patients receiving psycho-oncological care, and TA. Quality assess-
ment was undertaken using the Mixed Methods Appraisal Tool. Extracted
data were synthesized in tabular and narrative form.
Result: Out of 4.647 search results, 24 quantitative, qualitative, and
mixed-methods studies were included in this review. Characteristics of
studies, interventions and samples were heterogenic. Overall high TA
scores were reported by patients. Favourable associations with distress
and well-being and mixed results for further outcome variables and com-
pliance were detected. For associations with (baseline) patient- and ther-
apist characteristics mixed results were revealed. Synthesis of qualitative
evidence pointed at a particularity of TA in psycho-oncology, e.g., patients
experiencing TA with their psycho-oncologist in the context of other
patient-provider relationships experienced due to the disease.
Discussion: is unique insight into the eld revealed a diverse and
quickly developing research eld. First hints towards the ecacy and par-
ticularity of TA in psycho-oncologic settings are delivered. Meanwhile it
is subject to limitations such as the great heterogeneity of studies and evi-
dence, hindering clear interpretations.
Conclusion: Results encourage to further focus on TA in psycho-oncol-
ogy, in research as well as in clinical practice - also in settings outside
traditional face-to-face contacts.
Disclosure Statement: e authors declare no conict of interest.
204
“The Ulm Treasure Chest” - a multimedia resource for dealing
with existential distress
Sarah Krämer; Klaus Hönig
Uniklinik Ulm Abt Psychosomatische Medizin und Psychotherapie, Ulm,
Deutschland
Background: e “Ulmer Treasure Chest” (UTC) is a free psycho-onco-
logical oering for individuals with palliative cancer who are parents of
minor children. It allows them to create an interview-based “Life Film
that captures biographical highlights, as well as wishes, advice, and mes-
sages for special moments. ese can then be passed on as a realistic
keepsake to their children and partners. Additionally, this oering aims
to support those aected in dealing with their existential burden, helping
them clarify their values and needs, draw a positive life balance, and shape
their farewell in a self-determined and dignied manner.
Methods: e exploration of existential topics is conducted using a
structured guide based on a meaning-oriented intervention specically
focused on preserving dignity (Dignity therapy). Films are created that
allow the bereaved to experience the deceased from multiple dimensions.
Result: Since 2022 10 lms were produced. Scientic evaluation started
2023. Funding is obtained through donations and third-party sources.
Public awareness has been achieved through internet and social media
presence, as well as newspaper articles, radio and television interviews.
Participant evaluations regarding the psycho-oncological preparation
using the guide, the lming location, styling, and on-site support from the
team have been consistently positive.
Discussion: Key positive aspects may include improved quality of life,
enhanced palliative treatment planning through increased awareness of
personal values and needs, acceptance of approaching mortality, positive
eects on partners, and a lasting “living” memory of the parent. Challenges
to be discussed include the nancial and logistical sustainability of the
oering, as well as the hurdles related to confronting ones own mortality.
Conclusion: e creation of a lm as a personal legacy, based on targeted
psycho-oncological exploration of existential burdens, holds various ben-
ets for patients, close people, and healthcare providers.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 183
210
Posttraumatic growth after cancer: a large-scale study of its
subdimensions and determinants
Patricia Blickle1,2; Martina Schmidt1; Karen Steindorf1
1Deutsches Krebsforschungszentrum (DKFZ), Abteilung Bewegung,
Präventionsforschung und Krebs, Heidelberg, Deutschland
2Universität Heidelberg, Medizinische Fakultät, Heidelberg, Deutschland
Background: e positive psychological change experienced aer a chal-
lenging life event, such as cancer, is dened as posttraumatic growth (PTG)
and has recently received increasing attention in cancer research. We
investigated the extent and longitudinal predictors of PTG in disease-free
cancer survivors.
Methods: Individuals with dierent types of cancer were included. Four
years aer diagnosis (t1), all ve subdimensions of PTG were assessed
using the 21-item PTG inventory: appreciation of life, relation to others,
personal strengths, new possibilities and spiritual change. Fatigue was
measured with the EORTC QLQ-FA12, pain with the EORTC QLQ-C30
pain items and emotional distress with the Patient Health Questionnaire
(PHQ-4) two years aer diagnosis (t0). Descriptive and multiple regres-
sion analyses were used.
Result: e mean age of the analyzed 1,316 cancer survivors (51.4%
female) was 67.2 years (SD=11.1) at t1. Regarding the extent of PTG, the
most positive developments were experienced in the PTG subdimension
appreciation of life (median (Q1-Q3) = 47.0% (20.0%-66.7%)), whereas
the subdimension spiritual change was the least pronounced domain
(10.0% (0.0%-40.0%)). Higher fatigue, pain and emotional distress were
longitudinal, but non-linear predictors of higher long-term PTG. Other
determinants of higher PTG were younger age, female gender and receipt
of chemotherapy. e better survivors felt informed about fatigue at t0,
the higher their PTG scores were.
Discussion: Many cancer survivors perceive positive personal changes
even years aer a traumatic cancer event, especially young people and
women. Higher PTG appears to be longitudinally associated with higher
levels of common cancer side eects.
Conclusion: Cancer survivors who are poorly educated about their symp-
toms are less likely to perceive positive changes, suggesting that psychoed-
ucational services may be helpful. Further research is needed on the role
of individuals knowledge in contributing to PTG.
Disclosure Statement: e authors declare no conict of interest.
213
Dreaming in Cancer Patients and their Partners - A
Quantitative Study with Dyadic Data
Sarah Salomo1; Tabea Hackl1; Birk Hagemeyer2; Jutta Hübner1
1Universitätsklinikum Jena, Klinik für Innere Medizin II, Hämatologie und
Internistische Onkologie, Jena, Deutschland
2Friedrich-Schiller-Universität Jena, Lehrstuhl für Persönlichkeitspsychologie
und Psychologische Diagnostik, Jena, Deutschland
Background: Sleep disturbances are a common side eect of cancer or its
therapy. ey can persist beyond the duration of therapy, impairing the
patients quality of life, but also inuencing the quality of sleep/life of their
intimate partners. Closely related to sleep quality, but so far hardly sys-
tematically studied in cancer patients, is the subjective dream experience.
Since dreaming is as well connected to quality of life, the aim of this study
was a quantitative analysis of the dream experience in cancer patients and
their partners with focus on possible interdependencies.
Methods: A cross-sectional study was conducted with 101 cancer patients
and their partners from an oncology day clinic and patient training ses-
sions. Participants completed questionnaires assessing demographic data,
disease-related information, treatment-related information, dream expe-
riences, sleep quality, and life satisfaction. Actor-partner-interdependence
models (APIM) were used to analyze the data.
Result: Both cancer patients and partners reported a signicant decrease
in sleep quality since the cancer diagnosis and were categorized as “poor
sleepers. Dream stability was signicantly correlated with life satisfaction
in patients, while positive and negative dream emotions were signicantly
correlated with life satisfaction in partners. Dream intensity indicated an
interdependency between patients and their partners in terms that very
intensive dreams of the intimate partner seem to negatively eect life sat-
isfaction in patients.
Discussion: Dream experiences has an impact on life satisfaction beyond
sleep quality in cancer patients as well as their partners. e results sug-
gest a possible interdependence between dream experiences of partners
and patients.
Conclusion: e study highlights the importance of considering dream
experiences as potential factors inuencing the quality of life in can-
cer patients and emphasizes the role of partners in understanding their
inuence.
Disclosure Statement: e authors declare no conict of interest.
221
Professional Grief Among Healthcare Professionals in Cancer
Care: A Scoping Review
Svenja Wandke1,2; Hannah Führes1; Mareike Thomas1; Klaus Lang3;
Martin Härter1; Karin Oechsle4; Isabelle Scholl1
1Universitätsklinikum Hamburg-Eppendorf, Zentrum für Psychosoziale Medizin,
Institut und Poliklinik für Medizinische Psychologie, Hamburg, Deutschland
2Universitätsklinikum Hamburg-Eppendorf, II. Medizinische Klinik und Poliklinik
(Onkologie, Hämatologie, Knochenmarktransplantation mit Abteilung für
Pneumologie), Hamburg, Deutschland
3Psychotherapeutische Praxis, München, Deutschland
4Universitätsklinikum Hamburg-Eppendorf, Palliativmedizin, Klinik und
Poliklinik für Onkologie, Hämatologie und KMT, Hamburg, Deutschland
Background: As cancer remains one of the leading global causes of
death, healthcare professionals (HCPs) in cancer care routinely encoun-
ter patients’ deaths. While they oen establish close bonds with their
patients, limited evidence exists on their grief over patient loss, termed
professional grief (PG). is scoping review aimed at identifying key
aspects, research gaps, and the frequency and intensity of PG of HCPs
working in cancer care.
Methods: We applied the Arksey and O’Malley framework1. e primary
search covered three databases (PUBMED, PsycINFO and PSYNDEX).
Empirical studies on HCPs’ reactions towards or coping with patient
deaths were eligible for inclusion. Two reviewers independently screened
titles and abstracts, and assessed full texts for eligibility.
Results: Aer screening 2,184 records and assessing 269 full texts for eli-
gibility, 30 articles were included. Studies predominantly originated from
North America and Israel and limited quantitative data became evident.
Within the cancer care context, HCPs demonstrated various grief symp-
toms, common ones like sadness and crying, along with distinct facets
such as feelings of guilt. Grief frequency varied highly. However, a distinct
denition of PG as well as a common terminology were notably absent.
Discussion: e lack of consensus on a concept denition and terminol-
ogy for PG weakens the reliability of existing evidence. Additionally, this
review accentuates the signicance of exploring PG across diverse cultural
contexts and occupational settings.
Conclusion: Future research should focus on rening the conceptualiza-
tion and measurement of PG, enabling more precise insights in diverse
cultural and occupational backgrounds. A need emerges for designing and
assessing tailored interventions, oering support to HCPs in eectively
managing and navigating the intricate landscape of PG in cancercare.
1 Arksey H & O’Malley L. Int J Soc Res Methodol.2005;8:1,19–32.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts184
296
“Self-direction and conformity?” Understanding personal
values of patients with advanced lung cancer in the hospital
setting
Matthias Villalobos-Bollen1; Jan Ole Ludwig1; Mara König1; Laura Unsöld1;
Anja Siegle2; Michael Thomas1
1Thoraxklinik am Universitätsklinikum Heidelberg, Heidelberg, Deutschland
2Duale Hochschule Baden-Württemberg, Stuttgart, Deutschland
Purpose: e aim of this study was to explore personal values of patients
with metastatic lung cancer and their role in the hospital setting.
Methods: Convergent mixed-methods design including collection of
quantitative data of patients (n=66) using the Human Values Scale, group
comparison aer a propensity score matching with the German cohort
of the 9th European Social Survey, semi-structured interviews (n=17)
and qualitative content analysis, integration of data using side-by-side
display. Patients were recruited in the Department of oracic Oncology,
Heidelberg University Hospital.
Results: Quantitative analysis shows that lung cancer patients prioritize
signicantly more the value dimensions of self-transcendence (univer-
salism, benevolence; p=0.03) and openness to change (self-direction,
stimulation; p=0.04). While values of conservation (conformity, tradition,
security; p=0.05) and self-enhancement (power, achievement; p=0.03) are
less important. Besides the armation of self-direction, qualitative data,
contrastingly, shows “conformity” with medical treatment decisions and
the importance of “security”, while revealing the systematic neglect of val-
ues in patient-physician conversations.
Discussion: Our study reveals that values guiding lung cancer patients
dier from the general population, underlining the importance of self-
direction especially at the end of life. Nonetheless, strong conformity
arises in regard to medical treatment decicions. is may show the need
of feeling secure in a complex and uncertain setting, but has also the risk
of over-treatment, particularly when considering the neglect of values
exposed.
Conclusions: Despite guideline recommendations that decision-making
in advanced cancer and especially at the end of life should be based on
patients’ values transfer into every-day practice still lacks the necessary
knowledge and skills. e exposed neglect of values in patient-physician
conversations may jeopardize goal-concordant care and the timely inte-
gration of palliative care.
Disclosure Statement: e authors declare no conict of interest.
362
Distress screening – the OptiScreen training for nurses
Lara Dreismann; Tanja Zimmermann
Medizinische Hochschule Hannover, Klinik für Psychosomatik und
Psychotherapie, Hannover, Deutschland
Background: Psycho-oncological screening is necessary to identify psy-
chologically distressed patients as many patients report increased distress
(approx. 50%) or a psychological disorder (approx. 30%). A special train-
ing on psycho-oncological screening (OptiScreen-training) for nursing
sta was developed and used in a pilot-study. e aim was to reduce bar-
riers in the screening process and to establish an interdisciplinary screen-
ing approach.
Methods: e OptiScreen-training consisted of three modules (psycho-
logical disorders/psychological distress, psychooncology, psychooncolog-
ical screening, communication in the screening process, selfcare) and was
was led by psychotherapists/psychooncologists. e N = 72 nurses who
participated in the 6-hour training evaluated the training with a pre- and
post-questionnaire.
Result: Overall, the results show high satisfaction (62.0-98.6%) with
the design and content of the OptiScreen-training. Personal uncertain-
ties were signicantly reduced by the training (t(63) = -13.322, p < .001,
d = 1.67). Feasibility and overall acceptability from the nursing perspec-
tive were achieved (69.0-94.3%).
Discussion: e OptiScreen-training contributes to minimize barriers on
the part of the treatment team to carry out the screening, inform about
psycho-oncology and to recommend appropriate support services to
patients. Further implementation and evaluation of the training in other
oncology settings is pending.
Conclusion: Trained stu might contribute to identify distressed patients
in a targeted manner in order to provide them with psycho-oncological/
psychotherapeutic care according to their needs.
Disclosure Statement: e authors declare no conict of interest.
390
Eects of Interventions Based on Interpersonal Psychotherapy
on Distress, Depression and Anxiety in Patients with Cancer: A
Systematic Review
Ebba Laing1,2; Jana Heinen1,2; Norbert Schäeler1,2; Stephan Zipfel1,2;
Andreas Stengel1,2,3; Johanna Graf1,2
1Department of Psychosomatic Medicine and Psychotherapy, University
Hospital Tübingen, Section Psychooncology, Tübingen, Deutschland
2Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital
Tübingen, Tübingen, Deutschland
3Charité Center for Internal Medicine and Dermatology, Department for
Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate
Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin
Institute of Health, Berlin, Deutschland
Background: Cancer patients experience signicant psychosocial distress
associated with cancer diagnosis, treatment, and subsequent life changes.
Stressors include interpersonal diculties such as loneliness, isolation,
thwarted belongingness, communication impediments, and interpersonal
conicts. Interventions are required that address these specic stressors.
Interpersonal psychotherapy (IPT) is a promising concept for the treat-
ment of psychosocial distress in cancer patients because it addresses inter-
actions and role transformations within a patients social network. e
aim of this review is to provide an overview of studies of interventions for
patients with cancer based on IPT.
Methods: A systematic review following PRISM guidelines was con-
ducted, including only randomized controlled trials of IPT-based
interventions in cancer patients with assessments of eects on distress,
depression, and anxiety.
Result: Eight studies were included in the review, sampling a total of 390
cancer patients. Seven out of eight studies assessed female breast can-
cer patients only. Two studies described IPT interventions and showed
stronger improvement in depression and anxiety compared to TAU and
equal improvement in depression compared to other psychotherapy inter-
ventions. Seven studies described remote interpersonal counselling (IPC).
One study found the intervention to be superior to control condition
regarding depression, and one study found the intervention to be superior
to attention control, but not active control conditions. No study found the
intervention to be superior to control conditions regarding distress.
Discussion: ere are few randomized control trials of IPT for cancer
patients. Results regarding depression and anxiety are promising for
in-person IPT, but mixed for remote IPC.
Conclusion: Concepts of IPT can be adapted to oncology settings. To
inform decisions on implementation of IPT interventions, research with
more diverse groups of cancer patients is called for.
PROSPERO ID. CRD42023410687
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 185
409
Online or face-to-face? The video consultation in oncology
Friederike Kendel1; Dorothee Speiser2; Ahmed Magheli3; Markus Feufel4
1Charité - Universitätsmedizin Berlin, Geschlechterforschung in der Medizin,
Berlin, Deutschland
2Charité - Universitätsmedizin Berlin, Zentrum Familiärer Brust- und
Eierstockkrebs, Berlin, Deutschland
3Vivantes, Klinikum Am Urban, Urologische Klinik, Berlin, Deutschland
4Technische Universität Berlin, Fachgebiet Arbeitswissenschaft, Berlin,
Deutschland
Background: ere is little known about how doctor-patient interaction
changes in the video consultation. erefore, the aim of the OVID study
was to describe quantitative and qualitative dierences between video
consultation (VC) and face-to-face consultation (FC) with regard to phy-
sician-patient interaction and to identify barriers to the use of VS.
Methods: We conducted a cross-sectional quasi-experimental study using
a mixed-methods design. e sample consisted of N = 73 cancer patients
and their physicians. We recorded and systematically compared VC and
FC regarding verbal and nonverbal aspects. In addition, we conducted
semi-structured interviews with 10 patients and 10 physicians.
Results: In the VC physicians had a higher proportion of speech and
asked fewer open questions than in the FC. e structure of the conver-
sation also diered. In the interviews, the most important advantages of
the VC mentioned by patients were the reduced travel, infection protec-
tion, and the familiar home environment. However, disadvantages such
as technical and organizational barriers were also mentioned, and there
were concerns that the quality of doctor-patient interaction might suer.
On the physicians’ side, advantages were mainly seen in infection control,
spatial independence, time eciency and improved health care in rural
areas. Both physicians and patients were condent that a positive physi-
cian-patient interaction could also be established in the VC.
Discussion and Conclusion: Challenging conversations are also possi-
ble in the VC. However, barriers must be removed to increase acceptance
and use of the VC. Solutions to technical and organizational diculties
are needed. In addition, doctor-patient communication in the VS also
requires new behavioural routines.
Disclosure Statement: e authors declare no conict of interest.
456
LOGOS - A hybrid intervention study of meaning-centered
psychotherapy for adult cancer survivors in aftercare
Annekathrin Sender; Lisa Schiebeck; Antje Lehmann-Laue;
Anja Mehnert-Theuerkauf
Universität Leipzig/Universitätsklinikum Leipzig, Medizinische Fakultät,
Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig,
Deutschland
Background: Living with a history of cancer is oen associated with
physical and psychosocial short and long-term eects. Existential distress
in coping with the disease is experienced by many cancer survivors and
remains an important factor even aer the end of treatment. Initial stud-
ies of meaning-centered psychotherapy (MCP) based on Breitbart (2017)
have shown high clinical ecacy in dealing with these existential issues.
Aim of the pilot study LOGOS is to adapt the MCP for cancer survivors
with a curative prognosis for the rst time in Germany.
Methods: Adult cancer survivors (n=36) are assigned to a group setting or
individual sessions (face-to-face or hybrid) and participate in eight man-
ualized MCP sessions over 16 weeks. Feasibility, satisfaction and initial
trends will be assessed by standardised validated questionnaires and qual-
itative interviews.
Result: First results and trends of the three measurement points (t0-base-
line; t1 aer 4 sessions, t2 aer 16 weeks) as well as specics of the hybrid
approach will be reported.
Discussion: MCP as a potentially highly relevant intervention for the
quality of life of cancer survivors can improve psycho-oncological sup-
port in aercare. With the completion of LOGOS, a proven manualized
group and hybrid individual MCP program will be available for cancer
survivors, providing insights into feasibility, acceptance, and satisfaction
with MCP in German speaking countries.
Conclusion: MCP for cancer survivors can enhance sense of purpose,
spiritual well-being and quality of life, and reduce anxiety and depressive
symptoms. e brief, structured and manualized MCP, which can be car-
ried out in hybrid setting and therefore independent of location, can pro-
vide psycho-oncologists an additional therapeutic tool.
Indication of source:
1 Breitbart, W. (Hrsg.). (2017). Meaning-centered psychotherapy in the cancer
setting: Finding meaning and hope in the face of suering. Oxford University
Press.
Disclosure Statement: e authors declare no conict of interest.
467
Implementation of a best practice guideline on
psychooncological screening at a comprehensive cancer
center – evaluation of the inuence of best practice on patient
care and patient-reported outcomes
Rebecca Bremen; Susanne Isfort; Jens Panse; Tim Henrik Brümmendorf;
A.Petermann-Meyer
Uniklinik RWTH Aachen, Klinik für Hämatologie, Onkologie, Hämostaseologie
und Stammzelltransplantation, Centrum für Integrierte Onkologie Aachen Bonn
Cologne Düsseldorf (CIO ABCD), Aachen, Deutschland, Aachen, Deutschland
Background: Comprehensive care for cancer patients (pts) should focus
on pts’ individual needs. us, all pts are to be screened for distress in
order to assure a timely identication of psychosocial burden and to initi-
ate adequate intervention. German experts consented a best practice (bp)
which provides guidance on psychoncological screening in comprehen-
sive cancer centers (CCCs) (Stengel et al., 2023). However, to date there
is a) no overview of the current screening processes, b) no comprehen-
sive implementation of the bp, c) a lack of evidence on the eect of bp
on screening rates and patient outcomes and d) a lack of information on
required resources for adapting bp. e oPoS study aims at systematical
implementation and evaluation of the bp at twelve wards of a German
center for integrated oncology (CIO).
Methods: Monocentric pilot study (07/23-06/24) with a mixed-method
approach in four phases: (1) state analysis, (2) bp implementation, (3)
patient survey and (4) evaluation.
Result: e study protocol will be provided in detail. e results of the
state analysis will be available at the congress and presented.
Discussion: e study presents a comprehensive and systematic approach
to the implementation and evaluation of bp guidelines at a CCC. e
pilot study uses a thorough design to translate guidelines into practice
and thereby generating valuable scientic and practical insights on a) the
current screening processes b) how to implement bp, c) the eects and d)
the resources required.
Conclusion: e study addresses a key aspect in comprehensive cancer
care. e study’s results will enable a more informed translation of best
practice guidelines on distress screening into clinical practice.
Indication of source:
1 Stengel, A., Dinkel, A., Karger, A. et al. Best Practice: psychoonkologisches
Screening an Comprehensive Cancer Centers. Forum 36, 278–283 (2021).
Disclosure Statement: e authors declare no conict of interest. e study is an
investigator-initiated study funded by the Faculty of Medicine RWTH Aachen.
DRKS-ID DRKS00032286.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts186
486
Post-traumatic Growth in Breast Cancer Patients in
Association with Resilience, Self-ecacy, Optimism and
Positive Emotions - A longitudinal Study
Ute Berndt1; Katharina Schäfer2; Bernd Leplow3; Andreas Wienke4;
Christoph Thomssen5
1Department of Gynecology, University Hospital Martin-Luther-University
Halle-Wittenberg, Halle (Saale), Deutschland
2Department of Psychology, Martin- Luther- University Halle-Wittenberg, Halle
(Saale), Deutschland
3Department of Psychology, Martin- Luther- University Halle-Wittenberg, Halle
(Saale), Deutschland
4Department of Medical Epidemiology, Biostatistics, and Informatics,
Martin-Luther-University Halle-Wittenberg, Halle (Saale), Deutschland
5Department of Gynecology, University Hospital Martin-Luther-University
Halle-Wittenberg, Halle (Saale), Deutschland
Background: Breast cancer is a potentially traumatic experience oen
accompanied by emotional distress, anxiety and depression. However,
patients also report positive changes in association with their coping pro-
cess, known as post-traumatic growth (PTG).
Methods: is study aimed to assess PTG three times: aer diagnosis
(t1), six-months later (t2) and four to eight years aer diagnosis (t3).
Furthermore, the impact of personality traits (resilience, optimism,
self-ecacy) and positive emotions on PTG was investigated. One hun-
dred and thirteen women recently diagnosed with stage I to III breast
cancer were included in the study. ey completed self-report measures of
PTG, personality traits and positive emotions at three times. Additionally,
sociodemographic characteristics, emotional distress, anxiety and depres-
sion were measured.
Result: Sixty-two patients provided complete data. A repeated meas-
ures ANOVA revealed a signicant increase of PTG-scores from t1 to t2
(MDi=-5.7, p=.004, CI [-9.99; -1.51]) and t1 to t3 (MDi=-5.4, p=.01, CI
[-9.83, -0.91]) but not between t2 to t3 (p=1.0). However, the individual
PTG proles over time were heterogeneous. Moreover, a multiple linear
regression was performed to evaluate inuencing factors on PTG. Positive
emotions are predictors on PTG at t2 (β=.526, p=.003, CI [0.187, 0.864])
and t3 (β=.611; p<.001, CI [0.296; 0.926]. Resilience was inversely associ-
ated with PTG on t2 (β=-.606, p=.015, 95% CI [-1.09; -0.124]).
Discussion/Conclusion: PTG was mainly present in the rst six months
aer diagnosis. Positive emotions enhance PTG and should be supported
in psycho-oncological practice. Higher levels of resilience may lead to
a less traumatic experience, which is a predisposition for developing
ofPTG.
Disclosure Statement: e authors declare no conict of interest.
491
Distress and support needs among cancer patients and their
family caregivers
Felicitas Lingenhöl; Dirk Arnold; Georgia Schilling
Asklepios Tumorzentrum Hamburg, Standort Altona, Hamburg, Deutschland
Purpose: e psychosocial consequences of cancer for patients are inten-
sively studied. However, little is known about the psychosocial distress
of their family caregivers. erefore, this study assessed the distress
levels of 100 cancer patients and their family caregivers in comparison.
Furthermore, the dierences regarding distress between patients with var-
ious tumor entities and dierent disease settings were investigated.
Methods: e assessment was done once by means of the NCCN dis-
tress thermometer and its 36 items issue list in 100 cancer patients and
their family caregivers in dierent outpatient clinics at the Asklepios
Tumorzentrum Hamburg. All tumor entities were included.
Result: e median overall burden of cancer patients was assessed with
“6” on the scale of 0-10, whereas family caregivers scored “5”. 32% of the
patients expressed the wish to get support by a psycho-oncologist, as 25%
of the family caregivers did. 34% of the family caregivers indicated an
interest in having special consultation hour. Patients were more likely to
suer from physical problems such as fatigue or mobility, while family
caregivers reported more psychological burdens such as worries and fears.
e highest distress levels were reported by family caregivers of patients
with lung cancer (7) or with cancer recurrence (6).
Discussion: Some studies report that the family caregivers of cancer
patients suer even more from distress, than the patients themselves. In
contrast, this work found that the overall burden was about the same. But
our study gives more detailed insights in the issues patients and family
caregivers suer from.
Conclusion: In summary, in this work the distress of family caregivers of
patients with cancer is about the same than that of the patients themselves,
although he latter suer even more from fears and psychosocial burdens.
is is reected by the high proportion of family caregivers wishing spe-
cialized interventions. erefore, this work clearly shows the need for
specialized programs, like support groups or special consultation hours.
Disclosure Statement: e authors declare no conict of interest.
518
Screening psychosocial care needs in patients with glioma by
physician-led conversation versus questionnaires: a cluster
randomized controlled trial
Mirjam Renovanz1,2; Robert Kuchen3; Melina Hippler1; Martin Voss4;
Joachim Steinbach4; Michael Ronellentsch4; Almuth F. Keßler5;
Martin Misch6; Julia Sophie Onken6; Marion Rapp7; Lorenz Doerner1;
David Rieger1; Minou Nadji-Ohl8; Carolin Weiß Lucas9; Jan Coburger10;
Marcus Mehlitz11; Jürgen Meixensberger12; Michael Karl Fehrenbach12;
Naureen Keric13; Jens Wehinger14; Friederike Schmidt-Graf15; Jens Gempt16;
Marcos Tatagiba2; Ghazaleh Tabatabai1; Melanie Schranz3,17;
Susanne Singer3,17
1Neurologische Universitätsklinik | Universitätsklinikum Tübingen, Abteilung
Neurologie mit interdisziplinärem Schwerpunkt Neuroonkologie, Hertie Institut
für klinische Hirnforschung, Tübingen, Deutschland
2Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen,
Deutschland
3Institut für Medizinische Informatik, Biometrie und Epidemiologie,
Universitätsmedizin Mainz, Mainz, Deutschland
4Dr. Senckenbergisches Institut für Neuroonkologie, Frankfurt am Main,
Deutschland
5Neurochirurgie - Uniklinikum Würzburg, Würzburg, Deutschland
6Charité - Universitätsmedizin Berlin Klinik und Poliklinik für Neurochirurgie,
Berlin, Deutschland
7UKD - Klinik für Neurochirurgie, Düsseldorf, Deutschland
8Neurochirurgische Klinik | Klinikum Stuttgart, Stuttgart, Deutschland
9Uniklinik Köln, Köln, Deutschland
10Universitätsklinikum Ulm Klinik für Neurochirurgie, Ulm, Deutschland
11Krankenhaus der Barmherzigen Brüder Trier, Neurochirurgie, Trier,
Deutschland
12Klinik und Poliklinik für Neurochirurgie Universitätsklinikum Leipzig, Leipzig,
Deutschland
13Neurochirurgische Klinik und Poliklinik, Mainz, Deutschland
14Klinikum Ludwigsburg Klinik für Neurologie, Ludwigsburg, Deutschland
15Klinikum rechts der Isar der TU München - Klinik und Poliklinik für Neurologie,
München, Deutschland
16Neurochirurgische Klinik und Poliklinik am Klinikum rechts der Isar, München,
Deutschland
17Universitäres Centrum für Tumorerkrankungen, Universtitätsmedizin Mainz,
Mainz, Deutschland
Background: Patients with high-grade gliomas (HGG) suer from
increased distress. However, due to neurological/neurocognitive decits,
assessment is challenging. We evaluated whether psychosocial screening
can be improved by face-to-face ascertainment during doctor- patient-
consultation compared to using a questionnaire.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 187
Methods: In a two-arm multicenter cluster-randomized study with 13
centers we compared screening of HGG patients’ psychosocial distress in
doctor-patient-conversation (intervention group, IG) to assessment via
validated questionnaire (control group, CG). Patients with a glioblastoma
or a diuse glioma CNS WHO-grade 3 or 4 were included. e main out-
come was the proportion of HGG patients with increased psychosocial
distress who receive psychosocial care (PC).
Result: In total, 763 patients were enrolled, 506 patients were included
in the nal analysis. Mean age was 52 years (range 19-86), 286 were male
(56.5%), the majority diagnosed with a glioblastoma (294/506, 58.1%).
According to the emotional functioning scale (EORTC QLQ-C30),
302/506 patients (59.9%) showed relevant psychosocial burden [1]. e
frequency of patients reporting having received outpatient PC was simi-
lar in both groups (IG 60/168; 38% vs. CG 50/134; 41%, odds-ratio (OR)
0.85, p=0.53). In the IG, the proportion of burdened patients forwarded
to PC according to doctors’ report was higher (IG 46/168; 28.4% vs. CG
30/134; 23.6%, OR 1.24, p=0.67) as well as use of PC during inpatient care
according to medical records (IG 50/168; 29.8% vs. CG 29/134; 21.6%,
OR 1.35, p=0.43).
Discussion: Screening for distress in HGG patients via face-to-face con-
versation was comparable to screening via questionnaires in terms of
self-reported use of psychosocial services later on. Furthermore, it led to
increased doctor-reported and in medical records documented referral to
such services.
Conclusion: Our results show that HGG patients might benet from a
facilitated screening integrated in a patient-doctor consultation.
Reference:
1. Giesinger JM et al. J Clin Epidemiol. 2020, PMID: 31639445.
Disclosure Statement: e authors declare that there are conicts of interest.
econicts were submitted to the congress organizer KUKM GmbH and KUKM
can disclose them if needed.
613
Experiencing pancreatic cancer from a patient‘s perspective -
results of a grounded theory study on people with pancreatic
adenocarcinoma from Germany
Patrick Ristau1,2; Claudia Oetting-Roß3; Andreas Büscher1,4
1Witten/Herdecke University, Faculty of Health, School of Nursing Science,
Witten, Deutschland
2University of Lübeck, Institute for Social Medicine and Epidemiology, Nursing
Research Unit, Lübeck, Deutschland
3FH Münster, University of Applied Sciences, Münster School of Health, Münster,
Deutschland
4Osnabrück University of Applied Sciences, Faculty of Business Management
and Social Sciences, Osnabrück, Deutschland
Background: People with pancreatic cancer face many challenges, and
health status changes within a short period of time. To date, no com-
prehensive or cancer-specic trajectory model integrates the patient’s
perspective.
Methods: Following grounded theory methodology, data collection and
analysis were iterative. A total of 26 problem-centered interviews were
conducted with pancreatic cancer patients of all stages from Germany.
e transcripts were rst openly and later axially and nally selectively
coded.
Results: Being diagnosed with pancreatic cancer is a life-changing event.
Patients make a clear distinction between the pre- and post-diagnosis
period. Immediately aer diagnosis, they focus on mere survival, react to
short-term challenges, and search for answers to arising questions. is
initial phase is followed by a circular phase of living on with pancreatic
cancer: Patients adapt to the longer-term consequences of pancreatic can-
cer and its associated challenges. Meanwhile, they experience their lives
repeatedly threatened by follow-up examinations, fearing recurrence or
progression in this context.
Discussion: Within this study, some pancreatic cancer-specic peculiar-
ities in the disease experience could be elaborated, which seem to distin-
guish pancreatic cancer from other cancer entities. ese ndings enabled
the development of a pancreatic cancer-specic trajectory model based on
patients’ experiences, which considers all stages of the disease.
Conclusion: Experiencing pancreatic cancer diers from living with
other cancers. Particularly noteworthy is the repeated perceived threat to
life in connection with check-ups. Understanding the patient’s perspec-
tive on their disease enables health professionals to better address patients
needs, concerns, and fears.
Disclosure Statement: e authors declare no conict of interest.
630
Guideline-based, long-term care for children and adolescents
ve years after the end of cancer treatment (AELKI): Feasibility
and Acceptance of Psychosocial Aftercare
Lisa Hohls1; Hannah Schmidt1; Katja Baust2; Hera Becker1; Nicole Griech2;
Annecke Röttger1; Katharina Tetzner2; Anja Borgmann-Staudt3; Jörg
Faber4; Michael Frühwald5; Gabriele Escherich6; Gabriele Calaminus2;
Ingo Menrath1; Thorsten Langer1
1Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland
2Universitätsklinikum Bonn, Bonn, Deutschland
3Charité-Universitätsmedizin Berlin, Berlin, Deutschland
4Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz,
Deutschland
5Universitätsklinikum Augsburg, Augsburg, Deutschland
6Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
Background: In Germany, approximately 2100 children and adolescents
are diagnosed with cancer every year. Despite good long-term survival
rates, many patients are aected by late eects of the oncological disease
and therapy. Although long-term follow-up care as secondary prevention
is required, necessary structures have not yet been established nationwide
in the regular care. Especially psychosocial care is oen lacking. e aim of
this study is to evaluate a risk-adapted, multidisciplinary, guideline-based
long-term follow-up care with a main focus on psychosocial aercare.
Methods: In a cluster-randomized prospective multicenter study, opti-
mized aercare will be compared with standard treatment as usual (TAU)
in ten study centers in Germany. Five intervention clinics (each will
recruit 160 patients who have completed at least ve years of follow-up
care) will provide guideline-based interdisciplinary medical follow-up
and appointments up to four psychosocial consultations by a psychologist
or social worker, depending on individual needs. In an initial exploratory
analysis, the documentation of the psychosocial sessions is evaluated with
regards to potential factors inuencing the feasibility and acceptance of
the optimized treatment.
Result: Preliminary analyses demonstrate various challenges in imple-
menting risk-adapted, guideline-based, multidisciplinary aercare and
transition in clinical settings. With few exceptions, patients are generally
accompanied by their parents.
Discussion: Implications for future structuring and a needs-based, multi-
disciplinary adaptation of psychosocial services in long-term follow-up
care for families formerly aected by cancer are discussed.
Conclusion: Initial experience shows that both patients and health care
providers will benet from structured multidisciplinary care.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts188
659
How do health care providers manage acutely suicidal cancer
patients with limited life expectancy?
Till Johannes Bugaj1; Thomas Fehn2; Christina Sauer1;
Corinna Seliger-Behme2
1Department for General Internal Medicine and Psychosomatics, University
Hospital Heidelberg & National Center for Tumor Diseases (NCT), University
Hospital Heidelberg, Heidelberg, Deutschland
2Department of Neurology, University Hospital Heidelberg, Heidelberg,
Deutschland
Background: People suering from advanced cancer sometimes consider
suicide, e.g. because they fear dependence on others. Some health care
providers (HCP) consider it morally dicult to restrict the autonomy of
these patients. Although it should be beyond doubt that attention should
be paid to possible suicidality in cancer patients, there is reason to believe
that the well-described treatment pathway for acutely suicidal patients
(accommodation, even against the patients will) is sometimes disregarded
in the case of these patients. e aim of this study is to investigate treat-
ment pathways commonly used by various HCP to care for suicidal cancer
patients.
Methods: e study surveyed primary care physicians, practicing
oncologists, psychiatrists from hospitals with psychiatric emergency
departments, and psycho-oncologists working in Baden-Württemberg,
Germany. erefore, the authors constructed a questionnaire dealing with
suicidality in cancer patients utilizing quantitative and qualitative items.
Furthermore, case vignettes were generated to evaluate which treatment
pathways the HCP would take in a ctional patient case. Potential partic-
ipants were identied through a register search and then invited via email
to participate anonymously. With this email they also received access to
the online questionnaire (SoSci Survey GmbH). Data were downloaded
for analysis.
Results: Data collection was completed in August 2023. e following
response rates were recorded: Primary care physicians: 28/2.569 (1%),
oncologists 1/53 (1.9%), psychiatrists 1/87 (1.1%), psycho-oncologists
23/80 (28.8%). Data analysis will be completed by the time of the congress.
Discussion: A rst apparent result is the low study participation. However,
those who participated reported very dierentiated conicts and experi-
ences regarding this topic.
Conclusion: An initial review of the response rates and results of this
study suggests that suicidality in cancer patients is of varying importance
to dierent HCP.
Disclosure Statement: e authors declare no conict of interest.
667
Cancer counseling app for patients and their relatives.
Presenting the prototype developed through a series of
scientic and evidence-based steps
Natalie Röderer1; Tanja Bratan2; Mahsa Fischer3; Sebastian Kuhn4;
Hartmut Kopf 5; Claudia Schlüfter2; Shayan Momeni3; Alexander Wünsch1,6
1Universitätsklinikum Freiburg, Klinik für Psychosomatische Medizin und
Psychotherapie, Freiburg, Deutschland
2Fraunhofer-Institut für System- und Innovationsforschung ISI, Geschäftsfeld
Innovationen im Gesundheitssystem, Karlsruhe, Deutschland
3Hochschule Heilbronn, Fakultät Wirtschaft und Verkehr, Abteilung
Wirtschaftsinformatik, Heilbronn, Deutschland
4Philipps-Universität Marburg, Institut für Digitale Medizin, Marburg,
Deutschland
5Duale Hochschule Baden-Württemberg Villingen-Schwenningen, Studiengang
Sozialwirtschaft, Villingen-Schwenningen, Deutschland
6Inselspital, Universitätsspital Bern, Universitätsklinik für Medizinische
Onkologie, Bern, Schweiz
Background: Digital support services are being increasingly used in
psycho-oncology. Despite the growing availability of various apps, the
important impact factor of the relationship between patients and coun-
selors is oen neglected. Hence, the goal is to develop a smartphone
app for outpatients and their relatives that provides easy access for sup-
port and has a focus on the patient-counselor relationship. Here, we will
present the prototype, which has been developed through scientic and
evidence-based steps.
Methods: In a rst step, qualitative interviews on requirements for an
app have been conducted with patients, relatives and counselors. ese
interviews were transcribed, categorized and analyzed according to qual-
itative content analysis [1]. In a second step, an interdisciplinary consen-
sus of psycho-oncologists, health scientists, IT experts and a digital health
expert discussed the issue using an ethics canvas. Based on these results,
fundamental app content and functions were dened and developed. e
prototype was evaluated involving patients, relatives, and counselors.
Result: We derived the following three contents and functions of the app
from the development steps: provision of sound information, oer of psy-
chosocial interventions and - of particular importance - easy access to
counseling. A prototype has been developed.
Discussion: e app development is based on scientic results and incor-
porates input from patients, relatives and advisors. It has a great potential
e.g. for patients in rural areas, dealing with multiple burdens or language
barriers.
Conclusion: An app oers a good opportunity to complement psycho-on-
cological counseling in a sustainable way. We see the further development
of the app in integrating personal counseling in a blended counseling or
stepped care approach.
Indication of source:
[1] Kuckartz, U., & Rädiker, S. (2022). Qualitative Inhaltsanalyse: Methoden,
Praxis, Computerunterstützung (5. Au). Beltz Juventa.
Disclosure Statement: e authors declare no conict of interest.
668
Male counselees at the Hereditary Breast and Ovarian Cancer
Centre Berlin - characteristics and possible psychological
impact
Charlotte Koch1; Nanette Kalmbach1; Nora Amirpour-Mehrhof1; Jenny
Katharina Wagner1; Nicole Zilski1; Jens-Uwe Blohmer1; Dorothee Speiser1;
Ute Goerling2
1Charité – Universitätsmedizin Berlin, Zentrum Familiärer Brust- und
Eierstockkrebs, Klinik für Gynäkologie mit Brustzentrum, Berlin, Deutschland
2Charité Comprehensive Cancer Center, Berlin, Deutschland
Background: Hereditary breast and ovarian cancer syndrome mainly
aects women. However, it is crucial to recognize that men can also
develop genetic breast and prostate cancer, and carry pathogenic germline
variants such as those found in the BRCA1/2 gene. Previous studies have
shown that there are signicant gender dierences in the way genetic
counseling and family cancer risks are handled [1]. us, our objective
is to investigate the male population seeking genetic counseling for these
concerns.
Methods: We retrospectively collected data on men who presented for
genetic counseling and testing at the Hereditary Breast and Ovarian
Cancer Centre at Charité Berlin (HBOC) from 2016-2023. Demographic
data, family history of cancer and the result of the genetic testing were
evaluated. In addition, the men were sent a questionnaire that examined
motivation for the genetic test, psychological impact (using the MICRA
questionnaire), health awareness and coping mechanisms related to the
process.
Result: Within the specied time period, a total of N=324 men received
genetic testing at the HBOC-Centre Charité. Average age at testing was
52 years. N= 51 (16.2%) had cancer at the time of testing, of which N=35
(68.6%) had male breast cancer. A pathogenic variant was detected in
N=134 men (41.4%). e BRCA1 gene demonstrated the highest prev-
alence, with N=71 (21.9%) cases, followed by the BRCA2 gene (12.7%).
e results of the questionnaire on the psychological impact of the genetic
tests are still pending.
Discussion: Final results from our study will be compared to former stud-
ies and presented at the conference.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 189
Conclusion: In order to provide a gender-specic counseling service, it
is important to involve male family members and to be aware of possible
gender dierences in dealing with genetic testing and its results.
Indication of source:
1. Dwyer, A.A., et al., Coping response and family communication of cancer risk
in men harboring a BRCA mutation: A mixed methods study. Psychooncology,
2022. 31(3): p. 486–495.
Disclosure Statement: e authors declare no conict of interest.
687
Implementation of a psycho-oncological screening according
to the new DKG indicator: An interdisciplinary approach at the
Oncology Centre CIO Cologne
Daniela Breitschuh1; Johannes Bösche1; Barbara Strohbücker2;
Steen Krebs3; Scarlett Berressem3; Vera Schiewer1; Christian Albus4;
Christiana Muth1
1Department I of Internal Medicine, University Hospital of Cologne, Köln,
Deutschland
2Nursing development, University Hospital of Cologne, Köln, Deutschland
3CIO Cologne, University Hospital Cologne, Center for Integrated Oncology
Aachen Bonn Cologne Duesseldorf (CIO ABCD), Köln, Deutschland
4Department of Psychosomatics and Psychotherapy, University Hospital of
Cologne, Köln, Deutschland
Background: e introduction of a new certication-relevant indicator
for psycho-oncology (PO) screening of ≥65% requires structural change
processes in everyday PO care. An interdisciplinary, structural solution
approach for the implementation of a profound PO distress screening
(PDS) is shown.
Methods: e change process is based on an interdisciplinary quality
management of psycho-oncologists, nursing teams and experts, medical
and administrative sta. e cooperation is characterized by a partici-
patory process involving all hierarchy levels. A hybrid PDS (analog and
digital) system was developed using the distress thermometer. e imple-
mentation of the PDS in the central hospital information system enables
a continuous quantitative evaluation. A qualitative survey focusses on
employee satisfaction.
Result: Central process elements are consistently practiced interdiscipli-
nary as well as assumption of responsibility by nurses for the PDS and for
the assignment to the PO. Initial qualitative results show an increase in the
nurses’ experience of competence. In parallel, PO ratios increased from
5%-40% to 45%-80% within the rst follow-up quarter.
Discussion: e interdisciplinary process performance allows a break-
through in the improvement of the PO indicator. Enabling factors are
participatory process design involving all hierarchical levels and the
availability of oncology nursing experts, who act as change agents dur-
ing implementation. Inhibiting factors are dierent access routes from
the oncological treatment to PO care and incompatible documentation
systems. At the same time, the sharp increase in the number of PDS high-
lights the actual need for care, which is not covered by the psycho-onco-
logical sta under the given budgetary restrictions.
Conclusion: Meeting the new DKG requirements is made possible by
consistent interdisciplinary and participatory approach, as well as a bind-
ing assumption of responsibility with sucient resources.
Disclosure Statement: e authors declare no conict of interest.
692
The association between Health-Related Quality of Life
(HRQoL) and psychosocial burden of cancer patients during
psycho-oncological treatment – Results of a longitudinal
quantitative study
Lena Hagedorn1; Holger Schulz2; Katharina Scheold2
1Palliative Care Unit, Department of Oncology, Hematology and BMT, University
Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2Department of Medical Psychology, University Medical Center Hamburg-
Eppendorf, Hamburg, Deutschland
Purpose: A majority of cancer patients show high rates of psychological
burden and lower HRQoL. erefore, early diagnosis of psychosocial bur-
den and HRQoL in cancer patients is indicated. e aim of this study was
to assess the prognostic validity of the EORTC QLQ C30 questionnaire
to examine the association between HRQoL and psychosocial burden in
cancer patients undergoing psycho-oncological treatment.
Methods: A quantitative questionnaire survey was conducted among
cancer patients from the outpatient clinic for psycho-oncology at the
University Medical Center Hamburg-Eppendorf. Data was collected at
baseline (start of treatment; n=2489) and aer 6 months (n=677) of psy-
cho-oncology treatment. We used the functional scales (physical, role,
emotional, cognitive, social) and the global health status of the EORTC
QLQ C30 and related it to psychosocial burden (depression, anxiety,
distress) at both time points. As a primary outcome we analysed the
association between the level of functioning and global QoL at baseline
on depression aer 6 months. Data was analysed using multiple linear
regressions.
Results: Higher HRQoL at the beginning of psycho-oncological treatment
was associated with lower levels of depression at 6 months. e model
shows that HRQoL (at baseline) accounts for 28% (adjusted R2=.283) of
the level of depression at 6 months. In a further analysis only depression
at baseline was initially entered into the model as a predictor. Aerwards,
the HRQoL scales were also included as predictors. In summary, HRQoL
accounted for an additional 3% (R2=.026) of the variance in depression
at 6 months. Signicant predictors were physical functioning, cognitive
functioning, emotional functioning and global QoL.
Discussion: Aer adjustment for baseline depression, the results show a
weak association of HRQoL with psychosocial burden in the course of
psycho-oncology treatment.
Conclusion: Early assessment of psychosocial burden should be an
important measure to assess the long-term development of psychological
burden and the individual indication for treatment.
Disclosure Statement: e authors declare no conict of interest.
720
Piloting „Kurzzeitintervention Progredienzangst” (KIPA) – a
program to reduce Fear of Progression (FoP) in families with
a child with cancer
Jessy Herrmann1; Anja Santel1; Laura Schupp2; Florian Schepper2
1Elternhilfe für krebskranke Kinder Leipzig e.V., Leipzig, Deutschland
2Selbstständige Abteilung für Pädiatrische Onkologie, Hämatologie und
Hämostaseologie um Universitätsklinikum Leipzig, Leipzig, Deutschland
Background: For pediatric oncology patients and their parents in particu-
lar FoP is a long-lasting psychosocial burden. While promising programs
for adult patients exist, the specic needs in pediatric settings have not yet
been addressed.
Methods: We recruited twenty-two families with a child with cancer (age:
0-17 years) in acute treatment or follow-up care and elevated FoP-levels
of at least one family member. Either one parent (n=14), both parents
(n=2), or a parent-child dyad (n=6) could participate. Families were ran-
domly assigned to a waitlist control group with usual care (n=10) or eight
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts190
sessions KIPA (n=12) consisting of psychoeducation, anxiety exposure,
and resource activation. ey completed the FoP-Q-SF/P or C (12-item,
ve point Likert scale) at (pre-)baseline (P/BL), aer intervention (T1)
and four months later (T2). We calculated Wilcoxon-Mann-Whitney-
Tests and Hedges g eect sizes.
Result: When comparing KIPA with usual care, there is a signicant
decrease of parental FoP (W=78, p=.002) with large eect size (g=0.964)
and a non-signicant decrease of childs FoP (W=12, p=.313) with still a
medium eect (g=0.513). When analyzing all groups, parents (MFoP=36,05)
are more burdened with FoP than children (MFOP=27,5) and only parental
FoP lowers signicantly from BL to T1 (W=246, p<.001; g=1.057) and
remains stable until T2 (W=108, p=.819; g=-0.012).
Discussion: ese preliminary results suggest that KIPA can signicantly
reduce parental FoP. For children, this treatment approach also seems
promising. However, a signicant limitation of our data is the small sam-
ple size, particularly for children. eir poor participation may reect
their lower FoP burden.
Conclusion: KIPA represents an initial approach to treating elevated FoP
in pediatric oncology. Further testing of the ecacy of KIPA on larger
samples and catamnestic surveys to analyze long-term eects are needed.
Disclosure Statement: e authors declare no conict of interest.
753
Adapting Interpersonal Therapy for Psycho-oncological Care:
Addressing Distress and Depression in Cancer Patients
Rita Acebo
Uniklinik Tübingen, Tübingen, Deutschland
Background: A cancer diagnosis triggers signicant life changes and
an increased need for social support, oen accompanied by distress and
depressive symptoms in patients. Interpersonal erapy (IPT) is eective
in addressing these issues, making it suitable for psycho-oncological care.
is abstract discusses the development of an adapted IPT model for can-
cer patients with distress or depressive symptoms. e adaptation includes
classic IPT elements (grief, role transitions, disputes, decits) and inte-
grates mindfulness, cancer-related psychoeducation, self-care, and group
support.
Methods: We tailored a 12-week group psychotherapeutic program based
on strategies proven eective for cancer patients with distress or depres-
sion. We conducted a comprehensive needs assessment, adapting IPT
elements to address cancer-related role transitions, social dynamics, and
interpersonal diculties. Participants (diagnosed with cancer and at least
mild depressive symptoms) undergo pre-therapy psychological diagnos-
tics. We engage patients in dening personal therapy goals. Hybrid partic-
ipation options are oered, and psychosocial crisis care is available. Aer
completing the program, we assess outcomes, including distress reduc-
tion, improved quality of life, and reduced depressive symptoms.
Result: While the study is ongoing, our adapted IPT approach aims to
eectively address cancer patients’ multifaceted needs. Combining clas-
sic IPT with mindfulness, psychoeducation, and group support, we
anticipate reducing depressive symptoms and enhancing well-being and
relationships.
Discussion: We will discuss the benets and challenges of this approach,
considering preliminary data.
Conclusion: Addressing depression is crucial for cancer patients’ men-
tal health and overall well-being. Evidence-based IPT adaptation may
enhance psycho-oncological care. As data collection continues, we hope
to provide insights into this innovative approachs eectiveness.
Disclosure Statement: e authors declare no conict of interest.
796
Funding of outpatient cancer counseling centers by the health
insurance funds - Utilization and initial assessments by the
counseling centers and providers (the KEVA-study)
Jochen Ernst; Svenja Heyne; Anja Mehnert-Theuerkauf;
Charlotte Gmeiner; Maria Mahlberg; Susanne Kuhnt
Department of Medical Psychology and Medical Sociology, University Medical
Center Leipzig, Leipzig, Deutschland
Submission Type: poster presentation.
Purpose: Since 2020/21, the health insurance funds contribute to the
costs of outpatient psychosocial cancer counseling centers (Ambulante
Krebsberatungsstellen - KBS). Currently, there is no reliable data on the
implementation of this funding option. e research questions of our
evaluation study are therefore: (1) how is outpatient cancer counseling
in Germany positioned in terms of structural aspects, oers and quality
criteria (compared to study results from 2015/2016), (2) how do providers
and KBS evaluate the funding opportunity and what are the reasons or
barriers to non-use?
Methods: We conduct (1) a nationwide quantitative structural survey
with all KBS. e focus is on the structure of provision, e.g., oers, sta-
ing and nancing structure. To assess the use and implementation of the
funding oer, (2) qualitative interviews are conducted with selected KBS
and providers (quota sample, N=30 KBS resp. 11 providers).
Results: For the quantitative survey, we contacted N=174 KBS. Out of
these, N=100 have returned a complete questionnaire to date (response
rate=57.5%). e survey and data analysis will be completed by early 2024.
At the DKK we will present the results of the quantitative survey.
Discussion: e study will provide data to evaluate structural aspects and
quality criteria of KBS and describe changes compared to 2015/2016.
Conclusions: e data can be used to assess the situation of the KBS
in Germany in the context of the nancial contribution of the health
insurance funds and to discuss implications for further improved
implementation.
Disclosure Statement: e authors declare no conict of interest.
874
Dyadic coping of cancer patients and their partners: How does
it aect therapy adherence?
Anne-Kathrin Köditz1; Peter Hövel1; Anja Mehnert-Theuerkauf1;
Lisa Cossmann1; Ute Goerling2; Charis Haering3; Myriel Hermann2;
Beate Hornemann3; Hannah Reuter4; Tanja Zimmermann4; Jochen Ernst1
1Universitätsklinikum Leipzig/Medizinische Psychologie und Medizinische
Soziologie, Leipzig, Deutschland
2Charité Comprehensive Cancer Center, Charité - Universitätsmedizin Berlin,
Berlin, Deutschland
3Psychoonkologie, NCT/UCC - Nationales Centrum für Tumorerkrankungen
Dresden, Dresden, Deutschland
4Klinik für Psychosomatik und Psychotherapie, MHH - Medizinische Hochschule
Hannover, Hannover, Deutschland
Background: Coping of couples in which one partner is aected by cancer
is considered as a dyadic process (dyadic coping, DC). Little research has
examined the dependence of therapy-associated factors on the DC and on
the degree to which the two partners rate the DC in agreement (congru-
ence index, CI). We aim to identify the relationship between DC and CI in
patient-partner dyads and therapy adherence.
Methods: We report data from the study “Prevalence of mental disorder,
psychosocial distress and need for psychosocial support in cancer patients
and their relatives stratied by biopsychosocial factors. We analyze the
rst measurement time point within < 8 weeks aer diagnosis of a solid
cancer (t1) and the second 6 months aer t1 (t2). We used validated ques-
tionnaires (Dyadic Coping Inventory, dimensions of DC: positive, nega-
tive, delegated, common; Adherence Assessment Questionnaire). Analysis
was carried out using a logistical regression (DV: therapy adherence, IV:
DC and CI, medical and sociodemographic variables).
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 191
Result: We analyze 210 couples (patients: 63.8% men; average age 60.2y;
78.6% married). Most prevalent cancers were prostate (32.4%), breast
(12.9%) and skin cancer (7.1%). Signicant correlations as well as medium
and strong eect sizes (Cohens d) were found between the dyadic coping
of the patient and the partner at t1. e discrepancy between self-assess-
ment and external assessment of the DC mostly correlated signicantly
with r < .31. e average of therapy adherence at t2 was 1.85 (SD: 0.56;
Range: 1=good therapy adherence to 4=very high probability of non-ad-
herence). Multivariate relationships between therapy adherence and DC
will be presented at the congress.
Discussion: We aim to determine the extent to which the DC dimen-
sions and the CI of cancer patients and their partners inuence therapy
adherence.
Conclusion: e clinical implications for psycho-oncology care of a
possible link between dyadic coping as a resource to increase treatment
adherence will be discussed.
Disclosure Statement: e authors declare no conict of interest.
877
Supporting Shared Decision Making: Measuring AI-based
prediction of trust based on the patients behaviour
Serap Tari1,2; Andreas Klostermann3; Julian Koller4; Friederike Mumm5;
Kristian Unger1; Claus Belka1
1LMU Klinikum / Klinik für Strahlentherapie und Radioonkologie,
München, Deutschland
2Bayerisches Zentrum für Krebsforschung (BZKF), München, Deutschland
3Trust Driven, München, Deutschland
4Hochschule der Bayerischen Wirtschaft gGmbH, München, Deutschland
5LMU Klinikum / CCC LMU Psychoonkologie / Medizinische Klinik III,
München, Deutschland
Purpose: Patient trust in doctors plays a central role in medical encoun-
ters, particularly with respect to shared decision making (SDM). Little is
knownabout whether the dimension of patient trust in the doctor-patient
relationship can be predicted by using AI-based models based on patients
behaviour. e aim is to empower patients in order to have a positive
eect on SDM in oncology. We searched the literature to assess the rele-
vance of this topic.
Methods and Materials: Systematic PubMed literature search was con-
ducted using the following MeSH terms: “Cancer”, “oncology”, “trust,
decision, “decision making, shared”, “condence” and “intelligence,
articial”. PubMed hits were analysed for their relevance and classied
into the categories: Global publications on the topic, publications pro-
posing methods to measure trust, publications where SDM outcome
and trust have been correlated and articial intelligence (AI) in SDM as
such and specically in oncology. PubMed metrics were analysed using
Bibliometrix.
Results: SDM in oncology (MeSH terms) made its entry into PubMed in
2018. e topic has an average growth rate of 44% per year since then with
an actual total of 338 publications. 18 out of 338 publications were on AI
in SDM in general, one was on AI in oncological SDM. However, only four
out of those, in addition, were on patient trust. Four of the publications
aim to measure trust. None of them measure it by analysing the patients
behaviour. e most relevant keywords related to SDM in oncology
among cancer-related terms were communication, patient engagement,
and cancer screening.
Conclusion: Overall, while SDM in oncology becomes growingly import-
ant in biomedical research, as well as AI in SDM, the relevance of research
in terms of trust as a dimension and its potential in oncology has not
really been reected in recent years. So far, there are only few attempts to
structurally determine trust at all. Hence, our proposed approach to use
a KI-model for trust prediction promises potential for the deeper under-
standing and improvement of SDM in oncology.
Disclosure Statement: e authors declare no conict of interest.
878
Motives for using and recommending cancer counseling
centers – A multicenter qualitative study
Melanie Schranz1,2; Oliver Bayer1,2; Margret Xyländer3; Markus Besseler4;
Hanna Bohnenkamp5; Gudrun Bruns6; Norbert Gelse7; Andreas Ihrig8;
Silke Meier9; Franziska Petridis10; Evelyn Flohr-Schmitt11;
Alexander Wünsch12,13; Thorsten Meyer-Feil14; Susanne Singer1,2
1Institut für Medizinische Biometrie, Epidemiologie und Informatik (IMBEI),
Universitätsmedizin der Johannes Gutenberg-Universität, Mainz, Deutschland
2Universitäres Centrum für Tumorerkrankungen (UCT), Universitätsmedizin der
Johannes Gutenberg-Universität, Mainz, Deutschland
3Humboldt-Universität zu Berlin, Institut für Rehabilitationswissenschaften,
Berlin, Deutschland
4Bayerische Krebsgesellschaft e.V., München, Deutschland
5Hessische Krebsgesellschaft e.V., Frankfurt, Deutschland
6Tumor-Netzwerk Krebsberatung im Münsterland e.V., Münster, Deutschland
7zum Zeitpunkt der Studie Psychosoziale Krebsberatungsstelle,
Universitätsklinikum Tübingen, Tübingen, Deutschland
8Psychosoziale Krebsberatungsstelle Nordbaden, Universitätsklinikum
Heidelberg, Klinik für Allgemeine Innere Medizin und Psychosomatik,
Heidelberg, Deutschland
9Psychoonkologin Hamburg, zum Zeitpunkt der Studie Stiftung phönikks,
Hamburg, Deutschland
10Psychosoziale Beratungsstelle für Krebskranke und Angehörige, Karlsruhe,
Deutschland
11zum Zeitpunkt der Studie Bayerische Krebsgesellschaft e.V., München,
Deutschland
12Inselspital/Universitätsspital Bern, Medizinische Onkologie,
Psychoonkologischer Dienst, Bern, Schweiz
13Psychosoziale Krebsberatungsstelle am Tumorzentrum Freiburg - CCCF in
Kooperation mit dem Universitätsklinikum Freiburg, Freiburg, Deutschland
14Universitätsmedizin Halle, Institut für Rehabilitationsmedizin, Halle (Saale),
Deutschland
Background: Cancer patients and their relatives face not only physical
but also psychosocial problems and challenges as a result of the disease.
Cancer counseling centers (German: Krebsberatungsstellen, KBS) oer
psychosocial support, however are not always used by those in need. What
makes patients and relatives as well as health care providers open to use
respective recommend it?
Methods: Semi-structured interviews were conducted in a Germany-wide
qualitative study. A total of 43 patients and relatives were interviewed face-
to-face by trained sta in 10 KBS; 30 referrers (i.e. physicians, psychother-
apists) were interviewed via telephone. All interviews were transcribed
verbatim and analyzed by means of thematic coding sensu Mayring.
Result: Patients and relatives seek KBS because they suer from dierent
straining conditions such as anxiety, helplessness, despair and disorien-
tation. ere were clients who mainly looked for professional support to
clarify socio-legal issues and bureaucratic matters and to talk to someone
outside their family or social environment to work through their emo-
tional problems. Referrers recommend KBS to provide help to patients
soon aer hospital discharge and when longer-term or intermittent sup-
port is needed in the outpatient setting. Respondents also indicated their
recommendation of KBS due to not having the professional expertise
regarding psycho(onco)logical or socio-legal issues. In addition, limited
time and sta resources were claimed as resulting in referrals to KBS.
Discussion: KBS are used or recommended for various reasons, especially
when psychosocial support is needed. Patients and relatives want to talk
to someone without burdening their family with their worries. is is
also a motive for the referring health care providers as they themselves
oen do not have adequate time for longer conversations with patients
and relatives.
Conclusion: KBS are used and recommended because they provide valu-
able psychosocial support and relieve not only patients and relatives, but
also referring health care providers.
Disclosure Statement: e authors declare the following: M. Schranz, O. Bayer,
M. Xyländer und T. Meyer-Feil geben an, dass kein Interessenkonikt besteht.
S. Singer erhielt Honorare für wissenschaliche Vorträge und Gutachten von Lilly
und Pzer – alle außerhalb der hier vorgestellten Studie. M. Besseler, H. Bohnen-
kamp, G. Bruns, N. Gelse, A. Ihrig, S. Meier, F. Petridis, E. Flohr-Schmitt und
A. Wünsch waren bzw. sind selbst Mitarbeiter/innen einer Krebsberatungsstelle.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts192
Radiation
52
Change in Tumor Volume at Boost Planning to Predict
Response to Chemoradiotherapy in inoperable stage III NSCLC
(TORCH study)
Simon Trommer1; Jörg-Andreas Müller1; Michael Oertel2; Felix Ehret3,4;
Siyer Roohani4; Tim Lange5; Matthias Mäurer6; Hai Minh Ha7; Quynh Ngo7;
Sophie Dobiasch8,9,10; Justus Domschikowski11; Eleni Gkika12;
Kathrin Hering13; Thomas Kuhnt13; Davide Scafa14; Maike Trommer15;
Maria Waltenberger8,10; Dirk Vordermark1,7; Daniel Medenwald1,7
1Universitätsklinik und Poliklinik für Strahlentherapie, Universitätsklinikum Halle
(Saale), Halle (Saale), Deutschland
2Klinik für Strahlentherapie - Radioonkologie, Universitätsklinikum Münster,
Münster, Deutschland
3Klinik für Radioonkologie und Strahlentherapie, Charité, Universitätsmedizin
Berlin, Berlin, Deutschland
4Klinik für Radioonkologie und Strahlentherapie, Charité - Universitätsmedizin
Berlin, Berlin, Deutschland
5Klinik für Strahlentherapie und spezielle Onkologie, Medizinische Hochschule
Hannover, Hannover, Deutschland
6Klinik für Strahlentherapie und Radioonkologie am Universitätsklinikum Jena,
Jena, Deutschland
7Universitätsklinik für Strahlentherapie, Universitätsklinikum Magdeburg A. ö. R.,
Magdeburg, Deutschland
8Klinik und Poliklinik für RadioOnkologie und Strahlentherapie am Klinikum
rechts der Isar, Technische Universität München, München, Deutschland
9Institut für Strahlenmedizin (IRM), Helmholtz Zentrum München, Neuherberg,
Deutschland
10Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site
Munich, München, Deutschland
11Klinik für Strahlentherapie (Radioonkologie), Universitätsklinikum
Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
12Klinik für Strahlenheilkunde, Universitätsklinikum Freiburg, Freiburg im
Breisgau, Deutschland
13Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Leipzig, Leipzig,
Deutschland
14Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Bonn,
Bonn, Deutschland
15Klinik und Poliklinik für Radioonkologie, Cyberknife- und Strahlentherapie,
Universitätsklinikum Köln, Köln, Deutschland
Background: In stage III non-small cell lung cancer (NSCLC), the use of
consolidating immunotherapy aer chemoradiotherapy (CRT) has shown
improved progression-free survival (PFS) and overall survival (OS). e
gross tumor volume (GTV) obtained from the boost planning computer
tomogram (BPCT) has been identied as a strong predictor of OS. e
TORCH study aims to investigate whether the GTV response at the time
of boost planning CT can serve as a predictor for durvalumab response.
Methods: is multicenter retrospective study evaluates the primary
endpoint of non-progression according to RECIST 1.1 criteria in patients
undergoing CRT in stage III NSCLC with a minimum cumulative dose of
60 Gy. Patients with WHO performance status ≥2, immunosuppression or
prior treatment with anti-PD1 or anti-PD-L1 antibodies were excluded.
GTV1 was dened at the beginning of CRT, GTV2 in the BPCT. Cox
regression was performed to assess the inuence of GTV change on PFS
and OS.
Result: e analysis included 139 patients so far, with 48 patients receiv-
ing durvalumab immunotherapy aer CRT. So far, no signicant impact
of GTV or its relative size change during CRT on PFS and OS could be
demonstrated. Within the subgroup of patients treated with durvalumab,
a trend towards improved PFS was observed in patients with greater GTV
shrinkage (p=0.059).
Discussion: While the trend towards improved survival in patients with
greater tumor shrinkage is promising, it did not reach statistical signi-
cance in this analysis. e ongoing recruitment of 200 patients may help
clarify this trend further. If the current trend is conrmed, early con-
solidation of immunotherapy aer CRT could be considered, given the
observed non-progression during the BPCT.
Conclusion: Recruitment is ongoing, and with the expected completion
of patient enrollment, the study aims to clarify the role of GTV response
as a predictor for durvalumab response in patients with stage III NSCLC.
Disclosure Statement: e authors declare the following: Forschungsunterstützung
durch AstraZeneca GmbH.
379
Patient Safety in German Radiation Oncology (PaSaGeRO) -
Development of an assessment instrument for patient safety
Andrea Baehr1; Eva Christalle2; Maximilian Grohmann1; Isabelle Scholl2
1Klinik für Strahlentherapie und Radioonkologie Universitätsklinikum
Hamburg-Eppendorf, Hamburg, Deutschland
2Institut und Poliklinik für Medizinische Psychologie Universitätsklinikum
Hamburg-Eppendorf, Hamburg, Deutschland
Purpose: Ensuring the quality of all steps in the radiotherapy process is
essential to safeguard the success of modern radiotherapeutic approaches.
Errors within this process can lead to adverse events, potentially even to
fatal outcomes. Consequently, the issue of patient safety (PS) within radi-
otherapy holds signicant importance. is study aims to establish a set
of PS indicators tailored specically for radiotherapy and develop a ques-
tionnaire for their assessment.
Methods: is mixed-method study is funded by the German Cancer Aid
as a multi-centre collaborative project spanning three years. We are cur-
rently conducting a literature review to identify potential PS indicators.
Subsequently, we will nalize PS indicator set through focus groups and
a Delphi study involving experts from all relevant professional groups.
Next, we will design and psychometrically assess a questionnaire intended
to evaluate these indicators, involving a minimum of n=153 participants
across multiple departments. Finally, we will assess the feasibility of
implementing the questionnaire in routine care.
Results: e project will yield a set of PS indicators grounded in a com-
prehensive literature review and validated by an expert panel. Moreover,
it will provide a psychometrically robust questionnaire for evaluating PS.
e trial implementation will allow us to identify barriers and facilita-
tors for questionnaire utilization. Additionally, we aspire to develop the
questionnaire into a digital tool, that highlights weaknesses and potential
enhancements within an institution.
Discussion and Conclusion: is project systematically addresses PS in
German radiotherapy. It introduces, for the rst time, the opportunity
to evaluate safety-eective processes and structures within individual
departments. e digital tool empowers professionals to self-assess PS
in their institutions conveniently. Furthermore, it contributes to raising
awareness of safety-related matters and enables institutions to compare
their processes with national and international recommendations.
Disclosure Statement: e authors declare no conict of interest.
415
Stereotactic Body Radiation Therapy (SBRT)in Functionally
Inoperable Patientswith Clinically Diagnosed Early-Stage
Lung Cancer: a Retrospective Single-Center Analysis
Karim El-Marouk; Julian Taugner; Esra Degerli; Lukas Käsmann;
Farkhad Manapov; Chukwaka Eze
LMU Klinikum Campus Großhadern, München, Deutschland
Background: Stereotactic body radiotherapy (SBRT) is the gold stand-
ard for early-stage lung cancer without surgical option. However, these
patients are oen unable to undergo biopsy due to increased risk asso-
ciated with advanced age or high comorbidity. erefore, clinical, and
radiological criteria indicating malignancy must be applied. is study
aimed to evaluate the ecacy and safety of empiric SBRT in presumed
early-stage lung cancer.
Methods: We performed a retrospective analysis of 57 patients with inop-
erable and clinically diagnosed lung cancer stage I/II. All patients were
treated with empiric SBRT without preceding biopsy. We included patient,
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 193
tumor, and treatment characteristics into the analysis to evaluate a possi-
ble association with overall survival.
Result: Median age at diagnosis was 70 years. Median follow up was 50.2
months and median overall survival was 41.7 months. Local control aer
1 year was 89%, and aer 2 years 77%. Most of the tumors were located
peripheral (64.9%). Central (28.1%) and ultra-central (7.0%) were seen
in less patients. Only one-fourth of patients reported new-onset dysp-
nea within the rst week aer SBRT. Among patients with an increase
in subjective dyspnea, median PFS was 16.6 vs. 32.7 months (p=0.004).
Furthermore, patients with newly developed suspicious lymph nodes aer
therapy had a signicantly inferior OS of 19.9 months vs. 69.2 months
(p= 0.045). All patients received SBRT to a BED of at least 100 Gy.
Discussion: In fact, most of the data found in the literature are pooled,
meaning that both patients with biopsy-proven disease and those without
a performed biopsy are included. All patients taken into our evaluation
were non-biopsy-proven due to their low tness.
Conclusion: Under the condition of an already poor prognosis in the
multimorbid population, empirical SBRT in presumed early-stage lung
cancer has been shown to be ecient and safe. Patients with newly devel-
oped suspicious lymph nodes in imaging aer therapy had a signicantly
inferior OS.
Disclosure Statement: e authors declare no conict of interest.
528
State of Digitalization in Radiation Oncology Departments:
Insights into Germany, Austria, and Switzerland by 2023
Maximilian Grohmann1; Stefan Janssen2; Rami El Shae3; Andrea Baehr1;
Sarah Stefanowicz4; Paul Martin Putora5; Stefan Knippen6; Marcus Beck7;
Patrick Clemens8
1Universitätsklinikum Hamburg-Eppendorf, Klinik für Strahlentherapie und
Radioonkologie, Hamburg, Deutschland
2Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für
Strahlentherapie, Lübeck, Deutschland
3Universitätsmedizin Göttingen (UMG), Klinik für Strahlentherapie und
Radioonkologie, Göttingen, Deutschland
4Medizinische Hochschule Hannover, Klinik für Strahlentherapie und Spezielle
Onkologie, Hannover, Deutschland
5Kantonsspital St. Gallen, Klinik für Radio-Onkologie, St. Gallen, Schweiz
6Helios Kliniken Schwerin, Klinik für Strahlentherapie, Schwerin, Deutschland
7Charité Universitätsmedizin Berlin, Klinik für Strahlentherapie und
Radioonkologie, Berlin, Deutschland
8Landeskrankenhaus Feldkirch, Abteilung für Strahlentherapie und
Radio-Onkologie, Feldkirch, Österreich
Background: Digitalization is revolutionizing healthcare, particularly
inuencing elds like radiation oncology where it enhances treatment
planning and elevates patient engagement. Understanding this digital
adoption is critical. Our study aims to assess this in German-speaking
radiation oncology departments.
Methods: A digital survey was conducted, consisting of 53 questions
that covered various aspects of digitalization including patient workow,
departmental organization, radiotherapy planning, and employee-related
aspects. e corresponding survey link was sent to all DEGRO (Deutsche
Gesellscha für Radioonkologie) -associated radiation oncology depart-
ments across Germany, Austria, and Switzerland.
Results: From the 354 clinics invited to participate, we received 120
forms that were eligible for analysis, yielding a response rate of 33%. Most
responses were contributed by physicians and medical physicists who are
at the forefront of digital transformation within their organizations. e
survey disclosed a diverse digital adoption landscape: Nearly 70% of the
responding departments have integrated electronic patient records, and
around 50% operate without paper. In contrast, more advanced digital
solutions like smartphone apps for patient-reported outcomes or special-
ized digital health platforms are seldom used. eres also a discernible
trend towards employing automated tools for tasks such as contouring
and treatment planning. Note: ese are selected key ndings.
Discussion: e survey underscores an uneven digital maturity in
German-speaking radiation oncology. Foundational systems like
electronic records are well-integrated, yet innovative tools lag behind. is
mismatch aligns with broader trends in German healthcare, highlighting
a need for focused advancement in cutting-edge digital solutions.
Conclusion: Our survey oers a snapshot of digital adoption, pointing
out both strengths and areas for targeted improvement. It serves as a guide
for DEGRO and policymakers, aiming to elevate the standard of care in
radiation oncology.
Disclosure Statement: e authors declare no conict of interest.
551
Automatized response-adaptive radiotherapy with integrated
patient-feedback for lung cancer
Susanne Schrof; Marcel Nachbar; Goda Kalinauskaite; Marcus Beck;
Sebastian Zschaeck; Daniel Zips; Carolin Senger
Charite, Klinik fuer Strahlentherapie und Radioonkologie, Berlin, Deutschland
Purpose: Dose escalation in standard chemoradiotherapy and sequential
immunotherapy for stage III NSCLC is limited by radiation induced tox-
icity. Adaptive radiation therapy (ART) is a new image-guided technology
that avoids overexposure of surrounding normal tissue by optimizing the
radiotherapy (RT) plan according to tumor shrinkage and intrathoracical
anatomical changes on a daily basis. Currently, due to associated increased
workload and economic burden, ART is not yet integrated in standard clini-
cal treatment. e aim of this study is to develop a digital workow that com-
bines autonomous image segmentation and RT planning tools with patient
feedback for an individualized, fast, systematic and automatized treatment.
Methods: In this prospective, non-interventional study, we apply
AI-based image segmentation on cone-beam CTs to analyze the tumor
volume and depict the thoracic anatomy of the day. We are monitoring the
radiation induced toxicity on a weekly basis using ePROMs and ePRTs.
An autonomous planning tool integrates anatomical changes and toxicity
and optimizes the RT plan accordingly.
Results: Our preliminary results from 10 included patients visualize sig-
nicant anatomical alterations, especially the volumetric tumor shrinkage,
which is up to 50% during RT. A gradual increase of treatment toxicities,
such as esophagitis, pain and fatigue can be observed in ePROMs and
ePRTs. We are dening anatomical and symptomatic triggers to RT plan
adaptations. Currently, we are estimating the actual dose to tumor, sur-
rounding lung tissue, heart and esophagus in conventional RT and are
simulating the ART dose reduction to these OARs.
Discussion: is non-interventional study oers a novel ART strategy by
involving not only daily imaging, but also patient feedback to reduce radi-
ation-induced toxicity. We hypothesize that ART can reduce OAR dose by
approximately 15%.
Conclusions: e overall goal of this study is to increase the local tumor
control rate, reduce radiation-induced toxicity and improve the overall
patient survival in future interventional studies.
Disclosure Statement: e authors declare no conict of interest.
647
Radiation-induced senescence in cancer-associated
broblasts
Nadine Wiesmann-Imilowski1,2; Rita Gieringer1,2; Johannes Kupka2;
Victoria Langer1; Sebahat Kaya1; Peer Kämmerer1; Juergen Brieger2
1University Medical Center Mainz, Oral and Maxillofacial Surgery, Plastic
Surgery, Mainz
2University Medical Center Mainz, Otorhinolaryngology, Mainz
Background: Strategies for tumor treatment were focused solely on tumor
cells for a long time. However, the complex tumor microenvironment has
signicant inuence on tumor progression. If radiotherapy is chosen,
which is the case in about half of all patients, then inevitably also the
adjacent cells such as cancer-associated broblasts (CAFs), are exposed
to radiation. Since it is well known that CAFs play an important role in
tumor progression, we investigated their reaction to radiotherapy.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts194
Methods: For our study we isolated primary CAFs from oral squamous
cell carcinoma tissue. ese cells were exposed to dierent radiation
regimes ranging from single-high-dose irradiation to fractionated mod-
els. Besides the analysis of cell death and radiation-induced senescence,
we also analysed the secretory phenotype.
Result: We found that CAFs exhibit a high level of radioresistance. Instead
of dying CAFs entered radiation-induced senescence. is state was char-
acterised by an increased beta-galactosidase activity and an arrest of the
cell cycle. Furthermore, a typical senescence-associated secretory phe-
notype (SASP) was observed. Senescence was initiated within one week
aer irradiation with a single dose of 16 Gy and observations over 50 days
showed the prolonged persistence of this condition.
Discussion: Senescence can have pro-tumorigenic eects which are
believed to be largely due to the secretion of various modulating factors
as part of the SASP. We were able to show here that senescent CAFs are
a rich source of secreted growth factors, which can facilitate tissue repair
through the modulation of immune responses and angiogenesis. However,
in a tumor context they might facilitate invasion, metastasis, angiogenesis,
and evasion from immunosurveillance.
Conclusion: A better understanding of the reaction of CAFs to radiother-
apy could help to intervene in these processes and prevent the development
of local recurrences and metastasis to distant sites following radiotherapy.
Disclosure Statement: e authors declare no conict of interest.
704
Clinical Experience of Dose escalated Intensity modulated
Proton Therapy for Skull Base/Cervical Spine Chordoma:
Results of the prospective ProReg and KiProReg studies
Dalia Ahmad Khalil1; Christian Bäumer2,3; Jörg Wul3; Zaneera Asim3;
Moritz Meyer4; Benjamin Kansy4; Kerstin Stähr4; Stefan Mattheis4;
Stephan Lang4; Sebastian Bauer5; Beate Timmermann3,6
1Department of Particle Therapy, West German Proton Therapy Centre Essen
(WPE), West German Cancer Center (WTZ), University Hospital Essen, Essen,
Deutschland
2Department of Physics, TU Dortmund University, Dortmund, Deutschland
1Department of Particle Therapy, West German Proton Therapy Centre Essen
(WPE), West German Cancer Center (WTZ), University Hospital Essen, Essen,
Deutschland
4Department of Otorhinolaryngology, Head and Neck Surgery, University
Hospital Essen, Essen, Deutschland
5Department of Medical Oncology, Sarcoma Center, West German Cancer
Center (WTZ), University Hospital Essen, Essen, Deutschland
6German Cancer Consortium for Translational Cancer Research (DKTK),
Heidelberg, Deutschland
Background: e study aimed to analyse the results of dose escalated
intensity-modulated Proton therapy (IMPT) in management of skull-base
and/or cervical spine chordoma.
Methods: Between 03/2016 and 01/2023, 53 patients with skull-base and/
or cervical spine chordoma underwent moderately hypofractionated
dose escalated IMPT. All patients included in the prospective ProReg
and KiProReg studies at West German Proton erapy Centre. IMPT
was implemented with an SIB schedule with5 x 2.1 Gy(RBE)/week to
73.5 Gy(RBE) for the high-dose volume, and 5 x 1.6 Gy(RBE)/week to 56
Gy(RBE) for the low-dose volume.
Result: Median age at radiotherapy was 54.8 years (range 2.7- 82.6 y).
Prior to radiotherapy, 4 patients underwent biopsy, 46 patients STR, and
3 patients GTR. ree patients out of 4 with undierentiated chordoma
received chemotherapy prior to radiotherapy. At the last follow-up (FU), 49
patients had median FU time of 33 months (range 6-80.7 months). irty
eight (77.6%) patients were progression-free. Four (8.2%) patients died
due to tumor-related causes, 11 (22.4%) patients developed progression
of the disease, 8 (16.3%) local recurrence, and 5 (10.2%) metastases, 3 of
them (6.1%) developed intraspinal metastases, and 2 (4.1%) surgical tract
metastases. Estimated 6-y OS, PFS, LRFS, and DMFS were 82%, 63.4 %,
74.8%, and 80.3 %, respectively. Patients with undierentiated chordoma
and unexpected chondroid chordoma had worse OS results in compari-
son to conventional chordoma (p<0.001). No dierence in survival results
regarding resection status. No Grade 3 late toxicities were observed.
Discussion: We reported good oncological results in comparison with
published trials.
Conclusion: Dose escalated proton therapy with IMPT-SIB is safe and
eective option in treatment of skull-base and/or cervical spine chor-
doma. Despite advances in surgical and radiotherapy techniques, local
and systemic control of chordoma is still challenging and raising the issue
about role of systemic therapy in treatment of chordoma.
Disclosure Statement: e authors declare no conict of interest.
705
Implementation of PET/CT in radiation oncology – a patterns-
of-care analysis of the German Society of Nuclear Medicine
(DGN) and the German Society of Radiation Oncology
(DEGRO)
Simone Wegen1; Ursula Nestle2,3; Constantinos Zamboglou3; Simon Kb
Spohn4,5; Nils Henrik Nicolay6; Wolfgang Fendler7; Adrien Holzgreve8;
Rudolf Werner9; Nina-Sophie Schmidt-Hegemann10
1Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of
Medicine and University Hospital Cologne, Cologne, Deutschland
2Kliniken Maria Hilf GmbH, Mönchengladbach, Deutschland
3Department of Radiation Oncology, University Hospital Freiburg, Freiburg im
Breisgau, Deutschland
4Faculty of Medicine - University of Freiburg, Berta-Ottenstein-Programme,
Freiburg, Freiburg im Breisgau, Deutschland
5Department of Radiation Oncology, University Hospital Freiburg, Freiburg im
Breisgau, Deutschland
6Department of Radiation Oncology, University Hospital Leipzig, Leipzig,
Deutschland
7Department of Nuclear Medicine, University Hospital Essen and PET
Committee of the DGN, Essen, Deutschland
8Department of Nuclear Medicine, LMU University Hospital, LMU Munich and
PET Committee of the DGN, Munich, Deutschland
9Department of Nuclear Medicine, University Hospital Würzburg, Würzburg,
Deutschland
10Department of Radiation Oncology, LMU University Hospital, LMU Munich,
Munich, Deutschland
Background: Use of PET/CT in radiation therapy (RT) has increased.
Radiation oncologists (RadOncs) have access to PET/CT with a variety
of tracers and use it for target volume denition. e German Society of
Nuclear Medicine (DGN) and the German Society of Radiation Oncology
(DEGRO) aimed to identify current patterns-of-care to improve interdis-
ciplinary collaboration.
Methods: We created a survey on participating RadOncs’ use of dif-
ferent PET tracers for tumor delineation and treatment planning. We
queried organizational information (xed time slots, use of PET with
immobilization device (RT-PET), nancial compensation) and used the
Likert-Scale for multiple-choice questions and a free text entry option
in multiple-select questions. e survey was distributed via the DEGRO
members mailing list.
Result: During the survey period (May 22nd - August 7th, 2023), a total of
156 RadOncs participated. Among these, 59% reported access to diagnos-
tic PET/CT within their organization/clinic and 24% indicated xed time
slots for their patients. 37% perform RT-PET and 29% stated the presence
of a a dedicated RT-technician during the examination. Beside FDG (high-
est use in lung cancer: 95%), diagnostic PSMA-PET/CT for RT of prostate
cancer is routinely used by 44% (64% in salvage-RT). Use of amino acid
PET in brain tumors and somatostatin receptor PET in meningioma is
low (19% and 25%, respectively). Scans are reimbursed through the pri-
vate health insurance (75%) or within the indications approved by the joint
federal committee (GBA, 59%). 98% of RadOncs agreed that PET impacts
target volume denition and 62% indicated an impact on RT dose. Nearly
8% of surveyed RadOncs used auto contouring in PET-planned RT.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 195
Discussion: is is the rst nationwide survey on the role of PET/CT
among RadOncs in Germany. We nd a high acceptance of PET results
for target volume denition and a high implementation also of PET trac-
ers beyond FDG.
Conclusion: PET/CT has become an important tool for RadOncs with
several indications. However, access is limited in several sites, especially
to dedicated RT-PET.
Disclosure Statement: e authors declare no conict of interest.
709
Long-term vision preservation after proton beam therapy in
patients with iuxta-foveal uveal melanoma
Johannes Gollrad1; Ysé Barreau1; Andreas Weber2; Antonia Joussen2;
Daniel Zips1; Alexander Böker2
1Klinik für Radioonkologie und Strahlentherapie, Charité - Universitätsmedizin
Berlin, Berlin, Deutschland
2Klinik für Augenheilkunde, Charité - Universitätsmedizin Berlin, Berlin,
Deutschland
Background: Although excellent local control and eye retention rates
are achieved with ocular proton beam therapy (PBT), long-term vision
preservation is oen challenging in patients with iuxta-foveal tumor loca-
tions. Despite the proximity of these tumors to the fovea (0-5 mm), some
patients present with good-to-normal vision at diagnosis. erefore, the
avoidance of severe radiation induced visual deterioration is a crucial
treatment objective. We investigated whether the unique dose-sparing
ability of PBT translates into vision preservation in these patients.
Methods: We reviewed tumor characteristics and visual acuity data of
patients with iuxta-foveal uveal melanoma located 0-5 mm from the fovea
and >4 mm from the optic disc, who presented with best-corrected visual
acuity (BCVA) >0.5 decimals at baseline and underwent curative PBT
with 60 CGE as primary treatment. We performed Time-to-event and cox
proportional hazard analyses to investigate the impact of tumor location
on vision preservation and to identify potential risk factors for visual dete-
rioration aer PBT.
Result: In total, 74 patients (mean age 64.2, median follow-up 76 months)
were included into the analyses. In patients with a tumor distance >2 mm
from the fovea, the mean initial BCVA changed from 0.93 (SD 0.21) to 0.7
(SD 0.29) decimals 5 years aer PBT. In patients with a tumor location
<1 mm from the fovea, mean BCVA deteriorated from 0.86 (SD 0.19) dec-
imals to 0.22 (SD 0.20) at 5 years. Cox regression identied the distance to
the fovea >1 mm as the most relevant factor for vision preservation (HR
0.32, 95% CI 0.13-0.78, p=0.013).
Discussion: Due to its precision, ocular PBT provides protection to the
central foveal areas and eectively contributes to the preservation of long-
term vision in patients with uveal melanoma in close proximity to the
fovea. is is only applicable to patients in whom the optic disc is not
exposed to irradiation.
Conclusion: Aer PBT, excellent visual outcomes are achieved in patients
with iuxta-foveal uveal melanoma >2 mm from the fovea.
Disclosure Statement: e authors declare no conict of interest.
717
Proton Therapy for Skull-Base/Cervical Spine
Chondrosarcoma: Results of the Prospective ProReg and
KiProReg studies
Dalia Ahmad Khalil1; Christian Bäumer1,2; Jörg Wul1; Moritz Meyer3;
Theresa Steinmeier1; Zaneera Asim1; Benjamin Kansy3; Kerstin Stähr3;
Stefan Mattheis3; Stephan Lang3; Sebastian Bauer4; Beate Timmermann1,5
1Department of Particle Therapy, West German Proton Therapy Centre Essen
(WPE), West German Cancer Center (WTZ), University Hospital Essen, Essen,
Deutschland
2Department of Physics, TU Dortmund University, Dortmund, Deutschland
3Department of Otorhinolaryngology, Head and Neck Surgery, University
Hospital Essen, Essen, Deutschland
4Department of Medical Oncology, Sarcoma Center, West German Cancer
Center (WTZ), University Hospital Essen, Essen, Deutschland
5German Cancer Consortium for Translational Cancer Research (DKTK),
Heidelberg, Deutschland
Background: To evaluate ecacy and safety of intensity-modulated
proton therapy with simultaneous integrated boost (IMPT-SIB) in
denitive or adjuvant management of skull-base and/or cervical spine
chondrosarcoma.
Methods: In the prospective ProReg and KiProReg studies, 31 patients
with skull-base and/or cervical spine chondrosarcoma underwent IMPT-
SIB at West German Proton erapy Centre between 01/2017 and 01/2023.
SIB schedule for denitive/additive radiotherapy was5 × 2.1 Gy(RBE)/w
to 69.3 Gy(RBE) for the high-dose volume, and 5 × 1.65Gy(RBE)/w to
54.45 Gy(RBE) for the low-dose volume. In the adjuvant setting, 5 ×
2.1 Gy(RBE)/week to 67.2 Gy(RBE) for the high-dose volume, and 5 ×
1.7 Gy(RBE)/week to 54.4 Gy(RBE) for the low-dose volume were
prescribed.
Result: 67.7% of patients received proton therapy at initial diagnosis and
32.2% were irradiated at recurrence. Prior to radiotherapy, two patients
underwent biopsy only, 26 patients STR, and three patients GTR. Two
patients missed oncological follow-Up (FU). For the remaining 29
patients the median FU time was 39.9 months and ranged between 5.45–
73.46 months. ree patients died during FU, in one patient the cause of
death was tumor-related and in two patients was not tumor-related. Two
patients developed local recurrence and no patients developed metastasis.
Estimated 6-y OS, DSS, and PFS were 80%, 91.7%, and 90.8%, respec-
tively. No Grade 3 late toxicities (cranial nerves/brainstem/temporal
lobes/spinal cord or brain complications) were observed.
Discussion: Published data of proton therapy in management skull-base
and/or cervical spine chondrosarcoma are sparse due to rarity of the dis-
ease and unavailability of the complex technique in most centers. Our
Results are comparable with the published literature.
Conclusion: IMPT-SIB is safe and eective in treatment of skull-base
and/or cervical spine chondrosarcoma not only as an adjuvant to surgery
but also in the denitive setting.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts196
734
Investigation of Radiation Sensitization in Patient-Derived
Head and Neck Squamous Cell Carcinoma Organoids
Lena Heiser1,2; Soňa Michlíko2,3; Antje Dietrich1,2; Claudia Ball1,4,5,6;
Dominik Haim6,7; Max Kemper6,8; Korinna Jöhrens9; Ivona Mateska6;
Mechthild Krause1,2,3,6,10; Annett Linge1,2,6,10; Daniel Stange6,11;
Elisa Thomas1,2,6,10
1German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer
Research Center (DKFZ), Heidelberg, Dresden, Deutschland
2OncoRay – National Center for Radiation Research in Oncology, Faculty of
Medicine and University Hospital Carl Gustav Carus, TUD, Helmholtz-Zentrum
Dresden – Rossendorf, Dresden, Deutschland
3Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology -
OncoRay, Dresden, Deutschland
4Translational Medical Oncology, Faculty of Medicine and University Hospital
Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
5Technische Universität Dresden, Faculty of Biology, Technische Universität
Dresden, Dresden, Deutschland
6National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden,
Deutschland
7Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie,
Universitätsklinikum C. G. Carus Dresden, Dresden, Deutschland
8Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde,
Universitätsklinikum C. G. Carus Dresden, Dresden, Deutschland
9Institut für Pathologie, Universitätsklinikum C. G. Carus Dresden, Dresden,
Deutschland
10Department of Radiotherapy and Radiation Oncology, Faculty of Medicine
and University Hospital Carl Gustav Carus, TUD, Dresden, Deutschland
11Klinik und Poliklinik für Viszeral-, Thorax- und Gefaßchirurgie,
Universitätsklinikum C. G. Carus Dresden, Dresden, Deutschland
Background: Previous data show that organoids can closely recapitulate
the characteristics of the tumor origin. Our aim is to establish organoids
derived from head and neck squamous cell carcinoma (HNSCC) patient
samples in order to investigate potential radiosensitizers for individual-
ized radiation oncology.
Methods: Organoids were established from fresh patient tumor and
normal tissue material according to Driehuis et al. 2020 (Driehuis et al.
2020, Nature Protocols) and characterized by histological staining and
DNA TSO500 panel and RNA sequencing. With six tumor lines, we per-
formed a drug screening using presto blue viability assay, where we tested
22potential radiosensitizing drugs aer 4 Gy irradiation. Methods for val-
idation of the screening results were established.
Result: Long-term culturing was possible in 24 out of 92 received spec-
imens (tumor/normal). Our established tumor organoids recapitulate a
squamous cell carcinoma phenotype in H&E staining and show typical
tumor mutations in genes like tp53, PIK3CA, EGFR and more. In the
drug screen, especially ATM- and EGFR-inhibitors showed a radiosen-
sitizing eect. To validate the potential hits, an organoid formation assay
was established, which enables investigation of clonogenic survival aer a
combined treatment with irradiation and drug application. A radiosensi-
tizing eect can be conrmed aer treatment with AZD0156, Afatinib or
Alpelisib in three organoid lines using this assay so far. AZD0156 shows
the greatest eect. Furthermore, gH2AX staining was established for irra-
diated organoids and is used for the validation of the screening results.
Discussion and Conclusion: Establishment of HNSCC organoids was
successful using our workow. ese 3D models can be used to screen for
potential radiosensitizers. For validation, we established an organoid for-
mation assay to determine the clonogenic survival as an important end-
point in radiobiology. Further investigations to compare organoids and
their corresponding tumor tissue are planned.
Disclosure Statement: e authors declare no conict of interest.
769
Stereotactic ultrahypofractionated MR-guided radiation
therapy for localized prostate cancer – rst results of the
prospective, multicenter SMILE trial
Stefan Körber1,2; Christoph Fink1; Jonas Ristau1,3; Carolin Buchele1;
Sebastian Klüter1; Jakob Liermann1; Philipp Hoegen1; Elisabetta Sandrini1;
Adriane Lentz-Hommertgen1; Lukas Baumann4; Nicolaus Andratschke5;
Michael Baumgartl5; Matthias Guckenberger5; Minglun LI6;
Michael Reiner6; Stefanie Corradini6; Claus Belka6; Juliane Hörner-Rieber1;
Jürgen Peter Debus1
1Klinik für Radioonkologie, Uniklinikum Heidelberg, Heidelberg, Deutschland
2Klinik für Strahlentherapie, Krankenhaus Barmherzige Brüder Regensburg,
Regensburg, Deutschland
3Klinik für Strahlentherapie, Maria Hilf Krankenhaus Mönchengladbach,
Mönchengladbach, Deutschland
4Institut für Medizinische Biometrie, Universität Heidelberg, Heidelberg,
Deutschland
5Klinik für Radioonkologie, Universitätsspital Zürich, Zürich, Schweiz
6Klinik für Radioonkologie, LMU Universitätsklinikum München, München,
Deutschland
Background: MR-guided radiation therapy (MRgRT) is a promising tool
for precise, adaptive and personalized irradiation. For the SMILE trial,
this modern technique was used for men with treatment-naïve prostate
cancer undergoing stereotactic body radiation therapy. Here we report on
the 3-months toxicity and patient-reported outcomes of the prospective,
multicenter phase II trial.
Methods: In total, 69 patients with localized prostate cancer were included
and underwent daily online-adaptive MRgRT across three European
university hospitals. Patients received no invasive procedures before or
during irradiation. e prescribed dose was 37.5 Gy in 5 fractions, with
an optional simultaneous boost of 40 Gy to the dominant intraprostatic
lesion. Toxicity data was dened according to CTCAE v. 5.0 and RTOG
and EORTC QLQ-C30 and PR25 scores were assessed upon radiother-
apy completion and at 6 and 12 weeks post-radiotherapy and compared
to baseline symptoms. Moreover, dose parameters were compared before
and aer online plane adaptation.
Result: We observed no grade 3+ toxicity according to CTCAE or RTOG
at the 12-week follow-up visit. Most frequent side eects were nocturia
and stool frequency. ere were no meaningful changes in the global
health status nor in relevant subscores. In a subgroup analysis of 32 men,
an adapted radiation plan was delivered in 95% of fractions. By daily
online adaptation, the mean planning target volume (PTV) coverage was
increased by 4.5%. Moreover, adaptation resulted in improved sparing of
organs at risk like the urethra.
Discussion: Daily online-adaptive MRgRT for treatment-naïve men with
localized prostate cancer led to favorable overall rates of acute GU and GI
toxicity. Most symptoms resolved within the initial 12 weeks of follow-up.
Conclusion: Initial ndings from the multicenter SMILE trial demon-
strated promising results regarding dose distribution, toxicity proles and
quality of life. However, an extended follow-up period is required to col-
lect long-term toxicity rates and oncological outcome parameters.
Disclosure Statement: e authors declare the following: is study was
funded by ViewRay. e industry sponsor had no role in the study design, data
collection, data analysis, interpretation, or the decision to publish the ndings. e
content of this article reects the independent views and research of the authors.
Andratschke, Corradini, Hörner-Rieber report honoraria from ViewRay.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 197
Rehabilitation, Sports Medicine, and
Long-term Burden in Cancer Survivors
1
Characteristics of exercise programs for cancer patients
in Europe and neighbouring countries: A comprehensive
overview and analysis
Annelie Voland1; Anna Campbell2; Joachim Wiskemann1
1AG Onkologische Sport- und Bewegungstherapie, Abteilung Medizinische
Onkologie, Nationales Centrum für Tumorerkrankungen (NCT) und
Universitätsklinikum Heidelberg, Heidelberg, Deutschland
2School of Applied Sciences, Edinburgh Napier University, Edinburgh, Scotland,
United Kingdom
Background: ere is strong evidence on the positive eects of physical
activity interventions in cancer patients. However, knowledge transfer
into practice and the implementation of cancer-specic exercise programs
are fragmentary and complex.
Objective: e aim of this study was to analyze existing cancer-specic
exercise programs in the European Union, United Kingdom and neigh-
bouring countries.
Methods: Data were systematically collected within a cross-sectional
quantitative survey based on the RE-AIM framework.
Results: We analysed 82 exercise programs from 16 dierent countries,
from which 33% were located in community-based settings and 31% in
hospital clinics. Most programs employed 1-5 employee within 1-2 pro-
gram locations, serving 50-150 patients per year. Up to 70% of surveyed
exercise programs collaborated with oncologists or oncology nurses.
Programs were delivered by various exercise professionals with diverse
educational levels and qualications such as academic degrees (52%) or
specic educational certicates (45%). Established programs reported a
high need of collaborations with health care professionals, educational
courses for trainers and the integration of programs into cancer care
systems. Program funding and health care professional support were the
most frequent barriers for program implementation.
Conclusion: Our survey suggests that a successful implementation of
an exercise program in the cancer setting requires a close interaction
and collaboration between the cancer clinicians and exercise providers.
Furthermore, specialised education in exercise oncology is needed for all
participating professionals. Based on these nding we present an exem-
plary pathway of exercise care in oncology.
Disclosure Statement: e authors declare no conict of interest.
48
Can Argentine Tango Support Quality of Life and Physical
Activity in Cancer Survivors?
Shiao Li Oei1; Anja Thronicke1; Jessica Groß2; Thomas Rieser1,3;
Sarah Becker2; Patricia Grabowski4,5; Gerrit Grieb6; Harald Matthes1,3;
Friedemann Schad1,4
1Forschungsinstitut Havelhöhe, am Gemeinschaftskrankenhaus Havelhöhe,
Berlin, Deutschland
2Brustzentrum, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Deutschland
3Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie,
Charité – Universitätsmedizin Berlin, Berlin, Deutschland
4Onkologisches Zentrum, Interdisziplinäre Onkologie und Palliativmedizin,
Gemeinschaftskrankenhaus Havelhöhe, Berlin, Deutschland
5Institut für Medizinische Immunologie, Charité – Universitätsmedizin Berlin,
Berlin, Deutschland
6Plastische Chirurgie und Handchirurgie, Gemeinschaftskrankenhaus
Havelhöhe, Berlin, Deutschland
Background: For cancer survivors, long-term health-related quality of life
(QoL) burdens are dicult to manage. A six-week Argentine Tango pro-
gram eectively improved QoL in breast cancer survivors, and the ques-
tion was whether this could be sustained over a 12-month period and how
this was related to physical activity.
Methods: Stage I-III breast cancer survivors with cancer-associated
fatigue were enrolled and 50 survivors received the Tango program and
were compared with a historical Control cohort (n= 108), who did not
participate in Tango. Using the European Organization for Research and
Treatment of Cancer Questionnaire C30 (EORTC-QLQ-C30) and the
German version of the Cancer Fatigue Scale (CFS-D) self-reported QoL
parameters were assessed and longitudinal changes and correlations were
evaluated. Adjusted multivariable linear regression analyses were per-
formed to analyze associations between QoL scales and physical activities.
Result: Among the 50 Tango participants, the improvement in physical
functioning was sustained at 6 months (p=0.01) and 12 months (p=0.02).
is was not the case for the Control group at 12 months. e physical
activity assessment showed that increased fatigue (p=0.0005) and pain
(p = 0.005) were associated with less sporting activities, but not with
dancing.
Discussion: Physical activity is known to support QoL, but especially can-
cer survivors with severe fatigue symptoms have inhibitions to engage in
physical activity. It was found that dancing activities did not interfere with
any of the QoL scales, so dancing may be a way to break this vicious circle
and motivate physical activity despite fatigue.
Conclusion: Argentine Tango may be an appropriate component of early
supportive and follow-up care programs, to promote physical activity and
QoL and ultimately to improve long-term clinical outcomes of cancer
survivors.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
56
VersKiK study on paediatric cancer survivorship: preliminary
results
Ekaterina Aleshchenko1; Pietro Trocchi1; Claudia Spix2; Hiltrud Merzenich2;
Thorsten Langer3; Christian Lüpkes4; Peter Ihle5; Jutta Küpper-Nybelen5;
Peter Kaatsch2; Iris Meier6; Dirk Horenkamp-Sonntag6; Patrik Dröge7;
Thomas Ruhnke7; Ursula Marschall8; Melanie Klein9; Katja Baust10;
Gabriele Calaminus10; Juliane Glogner10; Christian Apfelbacher11;
Enno Swart11
1Institute of Social Medicine and Health Systems Research, Faculty of Medicine,
Otto von Guericke University, Magdeburg, Deutschland
2German Childhood Cancer Registry, Division of Childhood Cancer
Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics,
University Medical Center of Johannes Gutenberg University Mainz, Mainz,
Deutschland
3University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck,
Deutschland
4OFFIS–Institute for Information Technology, Oldenburg, Deutschland
5PMV research group at the Department of Child and Adolescent Psychiatry,
Psychotherapy and Psychosomatics, University of Cologne, Köln, Deutschland
6Techniker Krankenkasse, Hamburg, Deutschland
7AOK Research Institute, Berlin, Deutschland
8BARMER, Wuppertal, Deutschland
9DAK-Gesundheit, Hamburg, Deutschland
10Department of Pediatric Hematology and Oncology, University Hospital Bonn,
Bonn, Deutschland
11Institute of Social Medicine and Health Systems Research, Faculty of Medicine,
Otto von Guericke University, Magdeburg, Deutschland
Cancer in childhood or adolescence and its treatment might cause a
range of late eects. e aim of the VersKiK-study is to provide evidence
about late eects, follow-up care and adherence to follow-up guidelines.
Additionally, we will study care needs of cancer survivors and their infor-
mal caregivers.
VersKiK has a mixed-methods design [1]. e quantitative part is a
non-interventional, retrospective observational cohort study of data from
the German Childhood Cancer Registry (GCCR) linked with insurance
claims data. To study adherence, intended treatment data for selected
diagnoses will be added. e qualitative part combines participant obser-
vation, narrative interviews and focus groups.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts198
We will investigate late eects and utilization of medical services for about
27.000 GCCR patients registered from 1991 and survived until 1.1.2017.
Adherence to follow-up guidelines will be studied in a group of approxi-
mately 8.000 survivors with selected diagnoses.
To explore needs and experiences during follow-up, we conducted 19
unstructured observations of follow-up appointments and 36 volunteer
interviews. Combining them, we described “survivorship pathways” to
discuss in focus groups with about 50 healthcare providers.
e growing group of survivors aer cancer in childhood or adolescence
is associated with an increasing demand for long-term medical and psy-
chosocial support. e study design provides comprehensive evidence
about late eects of childhood cancer and generates suggestions for fol-
low-up care organisation improvement.
Reference:
1 Aleshchenko E, Swart E, Spix C, et al. Long-term care, care needs and
wellbeing of individuals aer cancer in childhood or adolescence (VersKiK):
study protocol of a large scale multi-methods non-interventional study. BMC
Health Services Research 2022;22(1):1176. doi:10.1186/s12913-022-08549-3
[published Online First: 20 September 2022].
Disclosure Statement: e authors declare no conict of interest.
212
Metastatic breast cancer patients’ perspectives on exercise – A
European mixed-methods study
Johanna Depenbusch1,2; Maike G Sweegers3,4; Neil Aaronson4;
Yvonne Wengström5; Malin Backman5; Nadira Gunasekara6;
Dorothea Clauss6; Melanie Schranz7; Britta Büchler7;
Juan Ignacio Arrarás8; Mireia Pelaez Puente9,10; Milena Lachowicz11;
Anne May12; Martijn M Stuiver3,4; Karen Steindorf1,2
1Division of Physical Activity, Prevention and Cancer, German Cancer Research
Center (DKFZ) Heidelberg, Heidelberg, Deutschland
2National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership
between DKFZ and University Medical Center Heidelberg,
Heidelberg, Deutschland
3Center for Quality of Life, Netherlands Cancer Institute/Antoni van
Leeuwenhoek Hospital, Amsterdam, Niederlande
4Department of Psychosocial Research and Epidemiology, Netherlands Cancer
Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, Niederlande
5Division of Nursing, Department of Neurobiology, Care Sciences, and Society,
Karolinska Institute, Stockholm, Schweden
6Department for Molecular and Cellular Sports Medicine, German Sport
University Cologne, Cologne, Deutschland
7Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI),
University Medical Center of the Johannes Gutenberg University Mainz,
Mainz, Deutschland
8Oncology Departments, Complejo Hospitalario de Navarra, Pamplona, Spanien
9Onkologikoa, San Sebastian, Spanien
10Faculty of Health Sciences, Universidad Europea del Atlántico,
Santander, Spanien
11Department of Oncology and Radiotherapy, Medical University of Gdańsk,
Gdansk, Polen
12Julius Center for Health Sciences and Primary Care, University Medical Center
Utrecht, Utrecht, Niederlande
Background: Exercise is a promising supportive care strategy for patients
with metastatic breast cancer (mBC), but research on the patients’ per-
spective is limited. e current mixed-methods study aimed to investigate
mBC patients’ views on exercise programs.
Methods: Patients with mBC from ve European countries (DE, ES,
NL, PL, SE) were invited to a semi-structured focus group (N = 44) or
a cross-sectional online survey study (N = 420) assessing attitudes and
knowledge towards exercise, physical activity levels, and exercise barri-
ers, facilitators, and preferences. Focus group discussions were audio- or
videotaped, transcribed verbatim, and translated into English. Relevant
statements were thematically coded with an iterative coding framework.
Survey data was analyzed with descriptive statistics.
Result: e study participants expressed positive attitudes and high
exercise intentions. While about half of the mBC patients reported to
know how much exercise they needed, only 8% actually knew current
exercise guidelines. is was also reected in low levels of higher-
intensity aerobic activities and resistance exercise. e main cited exer-
cise barriers were ‘no access to exercise programs for cancer patients
(27%) and ‘feeling too weak’ (23%) or ‘too tired’ (23%). Focus group
discussions revealed that such physical barriers also led to insecurities.
Patients thus wished for individual tailoring of exercise and professional
supervision. Other facilitators were ‘previous positive physical (72%) or
emotional (68%) exercise experiences’ (survey) and social interaction in
group training (focus groups).
Discussion: Despite positive attitudes, physical restrictions and insecuri-
ties hinder some patients with mBC from exercise engagement. To help
patients’ overcome such barriers, exercise programs should be adjusted to
the individual needs and preferences and include professional supervision.
Conclusion: Individually tailored and supervised exercise programs
might help to improve exercise participation in patients with mBC.
Disclosure Statement: e authors declare no conict of interest.
425
Functional Fitness in Cancer Patients and Survivors
Frieder Krause1; Soe Nieland2; Katharina Graf1; Elke Jäger3; Lutz Vogt2
1Krankenhaus Nordwest, Klinik für Onkologie und Hämatologie, Institut für
onkologische Sport- und Bewegungstherapie, Frankfurt am Main, Deutschland
2Goethe-Universität Frankfurt am Main, Institut für Sportwissenschaften,
Abteilung Sportmedizin, Frankfurt am Main, Deutschland
3Krankenhaus Nordwest, Klinik für Onkologie und Hämatologie, Frankfurt am
Main, Deutschland
Background: Cancer patients commonly show a loss in quality of life and
functional capacities. e ECOG status is used to determine functional
status, but there is a lack of objective measures to determine functional
tness. is study evaluated the functional status of cancer patients using
the Senior-Fitness-Test (SFT) [1].
Methods: Patients during or aer anti-cancer treatment were recruited for
this study. Using the SFT, functional tness was assessed by a trained exer-
cise scientist. ECOG status was extracted from current medical records or
determined by a senior researcher using ocial rating descriptions [2].
For each SFT item, individual results were assigned to an age referring to
normative values [3]. Fitness age (FA) for each participant was dened as
the mean age from all seven items.
Results: A total of n=30 subjects (f=15, 61.6±12.1y, 16 during & 14 aer
therapy) participated in this study. FA diered signicantly from bio-
logical age (+8.59 years, 95%-CI: 3.65-13.5, p<.001) with no dierences
between therapy stages. Patients dened as limited in their functional sta-
tus (ECOG 1&2) showed no signicant dierence between FA and biolog-
ical age compared to patients with ECOG stage 0 (p=.346).
Discussion: Our results show that the SFT is feasible to assess the func-
tional status in cancer patients and survivors. Our sample showed an aver-
age functional tness comparable to healthy subjects almost nine years
older. However, these functional decits were not reected by the ECOG
status, nor diered between patients during or survivors aer therapy.
Conclusion: Our results underline the need for objective measures to
assess the functional status for tailored exercise programs to address long-
term functional limitations in cancer patients and survivors.
References:
1 Rikli RE, Jones CJ. Journal of Aging and Physical Activity 1999; 7(2): 129–61.
2 Azam F, Latif MF, Farooq A, et al. Case Rep Oncol 2020; 12(3): 728–36.
3 Rikli RE, Jones CJ. Journal of Aging and Physical Activity 1999; 7(2): 162–81.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 199
536
Eects of exercise on fatigue and quality of life in metastatic
breast cancer patients: The randomized controlled
PREFERABLE-EFFECT study
Johanna Depenbusch1,2; Anouk E. Hiensch3; Martina Schmidt1,2;
Evelyn M. Monninkhof3; Mireia Pelaez Puente4,5; Dorothea Clauss6;
Philipp Zimmer6,7; Jon Belloso5; Mark Trevaskis8; Helene Rundqvist9;
Joachim Wiskemann2,10; Jana Müller2,10; Carlo Fremd2,10; Renske Altena11;
Joanna Kufel-Grabowska12; Rhode M. Bijlsma3; Lobke van Leeuwen-
Snoeks13; Daan Ten Bokkel-Huinink14; Gabe Sonke15; Bruce Mann16;
Prue Francis17; Gary Richardson18; Wolfram Malter19; Isabel Manuela
Álvarez López20; Elsken van der Wall3; Neil Aaronson15; Elżbieta Senkus12;
Ander Urruticoechea5; Eva Zopf8,21; Wilhelm Bloch6; Martijn M Stuiver15;
Yvonne Wengström9; Anne May3*; Karen Steindorf1,2*
*geteilte Letztautorenschaft
1German Cancer Research Center (DKFZ) Heidelberg, Heidelberg, Deutschland,
2National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership
between DKFZ and University Medical Center Heidelberg, Heidelberg,
Deutschland
3University Medical Center Utrecht, Utrecht, Niederlande
4Universidad Europea del Atlántico, Santander, Spanien
5Onkologikoa, San Sebastian, Spanien
6German Sport University Cologne (DSHS), Cologne, Deutschland
7TU Dortmund University, Dortmund, Deutschland
8Australian Catholic University, Melbourne, Australien
9Karolinska Institute, Stockholm, Schweden
10Heidelberg University Hospital, Heidelberg, Deutschland
11Karolinska Comprehensive Cancer Center, Stockholm, Schweden
12Medical University of Gdańsk, Gdansk, Polen
13Diakonessenhuis, Utrecht, Niederlande
14Alexander Monro Hospital, Bilthoven, Niederlande
15Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital,
Amsterdam, Niederlande
16Royal Melbourne Hospital, Melbourne, Australien
17Peter MacCallum Cancer Center, Melbourne, Australien
18Cabrini Hospital, Malvern, Victoria, Australien
19Womens Hospital, University Hospital Cologne, Cologne, Deutschland,
20Biodonostia, San Sebastian, Spanien
21Cabrini Health, Melbourne, Australien
Background: Exercise is an eective supportive care strategy for patients
with breast cancer in the curative setting, but evidence in patients with
metastatic breast cancer (mBC) is lacking. e PREFERABLE-EFFECT
study (NCT04120298) investigated the eects of exercise in patients with
mBC on fatigue, quality of life (QoL), and other cancer- and treatment-
related side eects.
Methods: e randomized controlled trial included patients with mBC
(ECOG performance status ≤ 2) from ve European countries (DE, ES,
NL, PL, SE) and Australia. Participants were randomly assigned to usual
care or a 9-month individualized, structured exercise program consist-
ing of 2x/week supervised aerobic, resistance, and balance training. e
primary outcomes, physical fatigue (EORTC QLQ-FA12 subscale) and
QoL (EORTC QLQ-C30 summary score) were assessed at baseline, 3, 6,
and 9 months. Changes from baseline to 3, 6 (primary endpoint), and 9
months were compared between groups using mixed models for repeated
measures. A signicant improvement of either or both primary outcomes
(Bonferroni-Holm adjusted) was considered as successful.
Result: A total of 357 patients with mBC were randomized (exercise=178,
usual care=179). Patients were on average 55.4 years old (SD=11.1) and
74.8% received 1st or 2nd line treatment. e exercise program resulted in
signicant positive eects on both primary outcomes. Physical fatigue
was lower (mean dierence: -5.3 [95% CI: -10.0; -0.6], p=.027, ES=0.22)
and QoL higher (+4.8 [2.2; 7.4], p=.0003, ES=0.33) in the exercise group
compared to usual care at the 6-month primary endpoint, as well as at 3
and 9 months. e 6-month analyses further yielded benecial exercise
eects on QoL subscales such as social functioning, pain, and dyspnea.
Two SAEs occurred (wrist and sacral stress fracture), neither related to
bone metastases.
Discussion: Our large multinational study demonstrated the ecacy of
supervised exercise during palliative treatment on mBC patients’ fatigue
and QoL.
Conclusion: Supervised exercise should be recommended during treat-
ment of mBC.
Disclosure Statement: e authors declare the following: Prof Prue Francis:
Honorarium from Eli Lilly (lecture on pregnancy/fertility in breast cancer)
564
Eects of the oncology rehab aftercare website Onko-Vital on
physical activity and relaxation behavior three and six months
after rehab discharge
Heike Kähnert1; Birgit Leibbrand2
1IfR, Norderney, Abt. Bad Salzuen, Bad Salzuen, Deutschland
2Salzetalklinik, Bad Salzuen, Deutschland
Background: A healthy lifestyle including physical activity and relaxation
behavior plays a major role in the rehabilitation of cancer patients. e
rehab aercare website Onko-Vital is designed to help cancer patients to
realize aercare goals regarding a healthy lifestyle in the long term. is
study examines the eectiveness of Onko-Vital (OV) in implementing
aercare goals (AG), sports activity (SA), and relaxation behavior (RB) up
to 6 months aer discharge.
Methods: Cancer patients (n=242) who underwent a rehab were ran-
domly assigned to the control (CG) or intervention group (IG). ey were
interviewed using self-report questionnaires at the beginning (t1), 3 (t3)
and 6 months (t4) aer discharge. While the CG received the usual care,
the IG additionally received the OV-intervention. Chi-square tests and
ANCOVA were applied to investigate dierences between CG and IG
regarding the AG, SA, and RB.
Result: Two commonly mentioned AG were: AG1: becoming more active
in sports (95%) and AG2: learning to cope with stress (78%). At t4, goal
achievement of more than 50% was signicantly higher in IG than in CG
(AG1: IG=58%; KG= 38%, p≤0.01, ɸ=0.207 / AG2: IG=57%; CG=33%,
p≤0.01, ɸ=0.240).
At t1, approximately 39% of both groups reported sports activity. At t3 and
t4, the proportion increased in both groups, but was signicantly higher
in the IG than in the CG in each case (t3: IG=78%, CG=61%, p≤0.01,
ɸ=0.180 / t4: IG=75%, CG=61%; p≤0.05, ɸ=0.151).
At t1, 17% practiced relaxation techniques in the total sample. e per-
centage increased in both groups, but was signicantly higher in the IG
than in the CG at t3 and t4 (t3: IG=45%, CG=32%, p≤0.05, ɸ=0.128 / t4:
IG=48%, CG=25%; p≤0.01, ɸ=0.240).
No group dierence in the average duration (min/week) of SA and RB can
be demonstrated at any measurement time point.
Conclusion: is study demonstrates that the Onko Vital website is a
useful intervention to improve goal implementation, sports activity and
relaxation behavior in cancer patients up to 6 months aer discharge.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts200
589
Pregnancies and childbirth following treatment with
BrECADD or eBEACOPP for advanced-stage Hodgkin
Lymphomain the GHSG randomized phase III HD21 trial
Justin Ferdinandus1,2; Gundolf Schneider1,2; Alden Moccia3,4;
Richard Greil5,6; Andrea Kerkho7; Sebastian Scholl8; Yon-Dschun Ko9;
Max Topp10; Joachim Beck11; Vladan Vucinic12; Wolfram Jung13;
Roland Schroers14; Andreas Rank15; Carla Damaschin1,2;
Anne Sophie Jacob1,2; Michael Fuchs1,2; Peter Borchmann1,2;
Karolin Behringer1,2
1Klinik I für Innere Medizin und CIO Aachen Bonn Köln Düsseldorf, Uniklinik
Köln, Köln, Deutschland
2Deutsche Hodgkin Studiengruppe (GHSG), Köln, Deutschland
3Oncology Institute of Southern Switzerland, Bellinzona, Schweiz
4Swiss Group for Clinical Cancer Research, Bern, Schweiz
5Universitätsklinik für Innere Medizin III, Uniklinikum Salzburg,
Salzburg, Österreich
6Arbeitsgemeinschaft medikamentöser Tumortherapie (AGMT),
Salzburg, Österreich
7Medizinische Klinik A, Universitätsklinikum Münster, Münster, Deutschland
8Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Deutschland
9Hämatologie, Internistische Onkologie, Johanniter-Krankenhaus Bonn,
Bonn, Deutschland
10Medizinische Klinik II, Universitätsklinikum Würzburg, Würzburg, Deutschland
11III. Medizinische Klinik, Universitätsmedizin Mainz, Mainz, Deutschland
12Klinik und Poliklinik für Hämatologie, Zelltherapie, Hämostaseologie und
Infektiologie, Universitätsklinikum Leipzig, Leipzig, Deutschland
13Klinik für Hämatologie und Medizinische Onkologie, Universitätsmedizin
Göttingen, Göttingen, Deutschland
14Hämatologie, Onkologie, Stammzell- und Immuntherapie,
Universitätsklinikum Knappschaftskrankenhaus Bochum, Bochum, Deutschland
15II. Medizinische Klinik, Universitätsklinikum Augsburg, Augsburg, Deutschland
Background: e phase III GHSG-HD21 trial compares BrECADD to
eBEACOPP in adult patients with newly diagnosed advanced-stage clas-
sical Hodgkin lymphoma (AS-cHL). Fertility is a major concern for the
mostly young patients with AS-HL. erefore, we analyzed pregnancies
and childbirth rates reported in HD21.
Methods: 1500 patients with AS-cHL aged 18-60 yrs were randomized to
PET2-guided 4-6 cycles of either eBEACOPP or BrECADD. Pregnancies
among patients or their partners were analyzed in female patients <40
yrs and male patients <50 yrs of the ITT cohort. Childbirth rates per
year were compared to population data for women between 18-40 yrs,
obtained from the German Federal Statistical Oce (Destatis). e trial
was registered at clinicaltrials.gov (NCT02661503).
Result: e nal cohort for this analysis comprised 1200 patients (496
female). 55.6% patients had cryopreservation prior to therapy. Aer a
median FU of 40 months, 126 pregnancies were reported in 97 (9.1%)
patients: 38 (7.2%) and 53 (9.8%) in eBEACOPP and BrECADD arm,
respectively. Compared to eBEACOPP, pregnancy rates following
BrECADD were higher in males (2.5% vs 5.7%) and females (11.8% vs
13.2%). Only 8.2% of patients with reported pregnancy made use of cry-
opreservation. 82.2% of all pregnancies resulted in childbirth and 17.9%
ended early. In women between 18 and 40 yrs, the childbirth rate per
year increased during the rst two years aer treatment (1st year: 0.6%;
2nd year: 4.4%) and numerically reached a higher rate compared to the
German reference population (6.5%) starting from the 3rd year (3rd year:
8.8%; 4th year: 8.0%; 5th year: 7.8%).
Discussion: We report high rates of pregnancies following chemotherapy
in the HD21 trial. Overall, childbirth rates in women aer the 2nd year of
FU are comparable to the German population. Compared to eBEACOPP,
pregnancy rates were twofold higher in partners of men who received
BrECADD and slightly higher in women.
Conclusion: Together with unparalleled primary cure rate achieved with
BrECADD, our data supports its use in young patients with a desire to
have children.
Disclosure Statement: e authors declare the following: Speaker fees from Roche
and Takeda Oncology.
655
Long-term cryostorage has no eect on vitality and motility
of spermatozoa – even in patients with limited semen
parameters
Simone Bier; Daniela Hanke; Michael Zitzmann; Verena Nordho;
Sabine Kliesch
Centre of Reproductive Medicine and Andrology, University Hospital of
Münster, Münster, Deutschland
Cryopreservation of human semen is mandatory to preserve a mans fer-
tility before initiation of gonadotoxic therapy. In healthy men with nor-
mal semen parameters it has been shown that aer 10 years of storage,
the quality of samples is restricted. However, data regarding patients with
malignant diseases and/or oligozoospermia are lacking but required for
adequate counseling. Semen parameters are oen reduced in men with
malignant diseases, which is assumed to be a paraneoplastic eect.
We have cryopreserved human semen samples of 6,022 patients before
the start of gonadotoxic therapy (data from years 2001- 2019). Of these
patients, 292 donated their cryopreserved samples for research aer
termination of their depot. We evaluated semen motility and vitality of
the freeze-thawed spermatozoa aer various duration of their storage
time and compared them to the initial values collected on the day of
cryopreservation.
Aer subdividing the samples into 3 groups according to duration-time
of storage (cryostorage time ≤ 5 years, n=49, between > 5 and ≤ 14 years,
n=213 and of more than 14 years, n=31) there were no signicant dif-
ferences of baseline values regarding sperm count, sperm concentration,
motility or vitality. Also none of the post-thawing values (motility or vital-
ity) were dierent (ANOVA for repeated measurements). Furthermore,
a regression analysis could not show a signicant eect of storage time
on motility or vitality (p=0.53 and p=0.64). Also in patients with oligo-
zoospermia, the regression analysis did not show a signicant eect of
the storage time on motility (p=0.99). However, baseline concentration as
well as motility were positively and signicantly related to these param-
eters post-thawing, irrespective of the time period the semen was stored
(p=0.02 and p=0.01).
Cryopreserved semen samples are not impaired due to long storage times.
We could show that long-term cryostorage of human spermatozoa is a safe
method and can reliably preserve fertility even in patients with restricted
semen parameters at the time point of cryopreservation.
Disclosure Statement: e authors declare no conict of interest.
665
Development of a multimodal therapy concept for the
rehabilitation of people with uveal melanoma
Oliver Kolbe; Lars Choritz; Kunert Kathleen S
REGIOMED Rehaklinik Masserberg, Abteilung Ophthalmologische
Rehabilitation, Masserberg, Deutschland
Background: Each year, approximately 1800 people are treated in acute
care for choroidal melanoma disease in Germany. e disease leads to
severe social and occupational barriers.
Methods: e specic occupational and social problems were analysed
by means of qualitative interviews with patients and experts at the only
German clinic for ophthalmology rehabilitation (REGIOMED Rehaklinik
Masserberg) and therapy options were developed.
Result: People with choroidal melanoma suer from the psychological
consequences of the cancer and the (functional) monocularity associated
with the therapy. ey have problems with balance and orientation, asso-
ciated posture problems due to e.g. compensatory head inclination and a
greater fear of falling. Occupational problems result from the limitations
of the visual eld, the specic demands of the occupation on spatial vision
and legal framework conditions (e.g. driving ability).
Discussion: Based on the identied problems, multimodal therapy options
were developed, such as a specic fall prevention training, a sports and
functional training to improve spatial perception or specic psychological
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 201
discussion groups. In combination with a general occupational orienta-
tion of the rehabilitation, a separate rehabilitation concept was developed.
e submission to the Deutsche Rentenversicherung (German pension
insurance) led to an approval for the rst ophthalmological follow-up
treatment (Anschlussheilbehandlung) in Germany.
Conclusion: People with uveal melanoma can start a rehabilitation with
a legal claim within the framework of a follow-up treatment that is geared
to their specic needs. A quantitative analysis of the eect of this reha-
bilitation on the quality of life related to the visual impairments relevant
to everyday life (based on the National Eye Institute Visual Function
Questionnaire, NEI-VFQ) is currently being performed.
Disclosure Statement: e authors declare the following: Beschäigungsverhältnis
an Klinik an der Konzept umgesetzt ist.
681
Information needs of cancer long-term survivors
Winja Weber1; Eva Baumann2; Evelyn Kludt1; Susanne Weg-Remers1
1Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
2Institut für Journalistik und Kommunikationsforschung, Hannover,
Deutschland
Background: In Germany, about 5 million people are cancer survivors –
over half of them received their initial diagnosis more than ve years ago.
ese long-term survivors and their relatives are oen confronted with late
and/or long-term eects of cancer or cancer therapy. In order to support
them with appropriate information, further knowledge about this target
group and their needs for information is important.
Methods: erefore, we analyzed N = 33,944 inquiries of cancer patients
or their relatives to a large provider of cancer information in Germany via
telephone or e-mail between 2019 and 2023.
Result: About a quarter of the inquiries were from individuals whose ini-
tial diagnosis was more than ve years ago (n = 9,075). e long-term can-
cer survivors were on average 63.6 years old and 66.3% female. In 77.2%,
the patients themselves inquired, in 22.8% their relatives did. e main
disease situation of the patients was relapse (36.8%), followed by the phase
aer initial treatment (29.6%), and a palliative situation (18.1%). e
dominating tumor regions were breast (42.7%) and male genital organs
(e.g. prostate, 22%). Overall, the information need was very high, in par-
ticular, for information on treatment (64.4% of all requests), living with
cancer (56.7%), contact details of providers (38.7%), and psychological
aspects (32.9%). Information needs of long-term survivors didn’t dier
signicantly from the need of people whose rst diagnosis was one to ve
years ago. However, dierences become apparent, when the patients had
metastases: ose patients mainly requested information on treatment
topics, while the information needs of patients without metastases and
their relatives primarily revolved around living with cancer.
Discussion/Conclusion: Long-term cancer survivors have a high and
wide-ranging need for information. In order to provide this heteroge-
neous target group with tailored information, characteristics such as their
disease situation in particular must be taken into account.
Disclosure Statement: e authors declare no conict of interest.
707
Expansion of urological therapy options in oncological
rehabilitation through digital forms of training
Ivonne Rudolph; Heiko Primus; Bettine Bilsing
Rehabilitationsklinik Bad Salzelmen, Schönebeck, Deutschland
Background: Visualizing and training body awareness are important
therapeutic components of sphincter and pelvic oor training to improve
continence status. In order to achieve this primary rehabilitation goal for
prostate patients in the best possible way, the Bad Salzelmen rehabilitation
clinic has introduced digital pelvic oor training since June 2023 in addi-
tion to the usual care program. is specic form of digital training uses a
digital sensor tube to measure the activity of the pelvic oor when you are
dressed. With this digital form of training, the rehabilitant should be able
to train an adequate control of the sphincter or pelvic oor.
Methods: A pilot study will start in September 2023 with the primary
study goal of evaluating the continence status in relation to expanding
the therapy spectrum through the digital form of training. e control
group receives the usual care program and the intervention group receives
a digital training session in addition to daily pelvic oor exercises. In
both groups, pelvic oor activity and the degree of urinary incontinence
(ICIQ) are determined at the beginning and at the end of the rehabilita-
tion. Furthermore, a 24-hour pad weight test is carried out at the begin-
ning and at the end of the rehabilitation. In addition, a follow-up aer 3
months is planned.
Result: e rst results are expected in spring 2024.
Conclusion: Digital therapeutic modules represent a promising addition
to previous usual care programs. e transfer of learned everyday exer-
cises can be supported in this way.
Indication of source: Baumann, F.T., Zopf, E.M. & Bloch, W. Clinical exercise
interventions in prostate cancer patients—a systematic review of randomized
controlled trials. Support Care Cancer 20, 221–233 (2012).
Disclosure Statement: e authors declare no conict of interest.
807
Similar EPOC patterns, but slower V
.O2 recovery kinetics
in cancer patients receiving immunotherapy compared to
survivors and heathy controls
Damir Zubac; Timo Niels; Freerk T. Baumann
Uniklinik Köln, Innere Medizin I, Köln, Deutschland
Introduction: Excess post-exercise O2 consumption (EPOC), a measure
of metabolic control in exercising muscles, is associated with O2 and ATP/
CP resynthesis aer aerobic exercise cessation. EPOC is well-studied in
healthy individuals, but theres a scarcity of data in clinical populations,
including cancer patients. We investigated EPOC kinetics aer moder-
ate-intensity cycling to enhance our understanding of metabolic regula-
tion in the active musculature following aerobic exercise cessation.
Methods: Twenty-one adults participated, grouped into cancer patients
undergoing immunotherapy (n=7, age 56±13), survivors (n=6, age
45±16), and healthy controls (n=8, age 45±13), cleared for two experi-
mental sessions. Initial data collection included body composition, medi-
cal history, and previous physical activity records. Participants underwent
a ramp V
.O2 peak test, followed by three step-transition tests progress-
ing to a 90% V
.O2 uptake of the gas exchange threshold (GET). is was
followed by a 30-minute GET cycling session, with simultaneous meta-
bolic and cardiovascular data collection. A 10-minute EPOC recording
followed test cessation.
Results: Peak V
.O2 and power outputs were higher in healthy controls
than in survivors and immunotherapy patients (both by ~20% p < 0.05).
Aer moderate-intensity cycling, cancer patients showed slower τV
.O2-o
kinetics by ~10 seconds compared to the other two groups, with similar
EPOC values (~1050 mL·O2) in all three groups.
Conclusion Slower recovery rates observed among immunotherapy
patients, combined with lower V
.O2 peak uptake, indicate an impairment
of muscular aerobic metabolism, resulting in decreased ability to toler-
ate aerobic exercise. e conclusions apply only to this group and study
design. Future research should consider age dierences in exercise inter-
ventions for better cardiometabolic outcomes.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts202
809
Study of long-term survivorship of lymphoma patients –
amulticenter longitudinal study of return to work and
quality of life
Ruth Elisa Eyl-Armbruster1; Julia Wendler1,2; Ramona Böttinger2;
Simone Neumaier1; Antje Jensch1; Susanne Walz1; Markus Knott1,2;
Susanne Rössle3; Nicola Giesen4; Jessika Strentzsch5; Veronika Schindler6;
Hans-Georg Kopp3,4; Jochen Greiner3,6; Claudio Denzlinger3,5;
Gerald Illerhaus1,2,3
1Stuttgart Cancer Center – Tumorzentrum Eva Mayr-Stihl, Klinikum Stuttgart,
Stuttgart, Deutschland
2Clinic for Hematology, Oncology and Palliative Care, Klinikum Stuttgart,
Stuttgart, Deutschland
3Department of health care research, Onkologischer Schwerpunkt Stuttgart e.V.,
Stuttgart, Deutschland
4Department of Hematology, Oncology and Palliative Medicine, Robert Bosch
Hospital, Stuttgart, Deutschland
5Department of Hematology, Oncology and Palliative Care, Marienhospital
Stuttgart, Stuttgart, Deutschland
6Department of Internal Medicine, Diakonie Hospital Stuttgart, Stuttgart,
Deutschland
Background: Due to improving treatment options over the past decades,
lymphoma long-term survivors and their ability to participate in work
substantially gain in importance. However, only a few studies have iden-
tied inuencing factors for their return to work process so far. us, this
study aims to investigate the association between demographic, psychoso-
cial, work-specic, and motivational factors in addition to medical aspects
and lymphoma patients’ return to work.
Methods: is longitudinal, multicenter study is planned and conducted
by the Stuttgart Cancer Center and 3 other clinics of the Onkologischer
Schwerpunkt Stuttgart. Patients with Hodgkins lymphoma, Mantel cell
lymphoma, Follicular lymphoma, and Diuse large B-cell lymphoma aged
18-65 years who receive systemic chemotherapy either at initial diagnosis
(ID) or relapse are included in our study. Partly abbreviated standardized
and validated questionnaires (e.g. COPSOQ, UWES, EORTC QLQ-C30)
assess patients’ work and life situation at ID as well as 6 and 12 months
aer the end of therapy. ese parameters are correlated with clinical
data (disease stage, prognosis scores, and ECOG PS). Patient recruitment
started in May 2021 and is ongoing.
Result: So far 47 patients agreed to participate. 51% of patients were
female, symptom burden was generally low (81% ECOG PS 0), 70% were
married or in a permanent relationship and 31% were solely responsi-
ble for the total household income. At ID 66% of patients were working
full time, 21% part time and 6% were unemployed. At 6 months, 65%
of patients reported no change in their working situation and only 10%
ofpatients had reduced their weekly working hours. e average time of
return to work was 17 weeks. Surprisingly, rst analyses did not show any
correlation between patients’ prognosis on their future return to work
and their current work situation. However, patients who reported higher
levels of fatigue and depression were less optimistic about their return
to work.
Disclosure Statement: e authors declare no conict of interest.
812
Polarized and Threshold Training Intensity Distribution in
Cancer Survivors: A randomized controlled trial
Nikolai Bauer1; Justine Schneider1; Kathrin Schlüter1;
Joachim Wiskemann1; Friederike Rosenberger1,2
1Nationales Centrum für Tumorerkrankungen (NCT) Heidelberg, Heidelberg,
Deutschland
2Deutsche Hochschule für Prävention und Gesundheitsmanagement,
Saarbrücken, Deutschland
Background: Polarized training intensity distribution is eective to
improve the endurance capacity of athletes. However, there is a lack of
research regarding the eects of polarized training intensity distribution
on endurance capacity in breast and prostate cancer survivors.
Methods: 28 breast cancer and 27 prostate cancer survivors were random-
ized to a polarized (POL, n = 27, age 60±8 years, VO2peak 23 mL·min-1·kg-1) or
threshold training group (T, n = 28, age 59±10 years, VO2peak 23 mL·min-
1·kg-1) and completed two sessions per week on a cycle ergometer over 12
weeks. Exercise duration was adjusted so that energy expenditure was the
same in both groups. Cardiopulmonary exercise and verication tests were
performed to determine endurance capacity (VO2peak, peak power output
(PPO), ventilatory threshold (VT1) and lactate thresholds (LT1 and IAT)).
Result: POL and T signicantly (p<.001) improved their endurance
capacity in terms of VO2peak (0.09 and 0.12 L·min-1), PPO (27 and 17W),
power output at VT1 (11 and 13W), oxygen uptake at VT1 (0.09 and 0.11
L·min-1), power output at LT1 (7 and 12W) and power output at IAT (12 and
14W). No dierence was found between training groups, however, thresh-
old training required signicantly (p<.001) less time than polarized training
(59±1 min/week vs. 76±11 min/week). Analysis of energy expenditure over
the course of the intervention also revealed no dierences between groups
(POL: 170±43 kJ/session, T: 175±35 kJ/session, p=0.10).
Discussion: Polarized training intensity distribution and isocaloric
threshold training produced comparable eects on endurance capacity in
cancer survivors, with threshold training requiring signicantly less time
to produce these eects.
Conclusion: We conclude that breast and prostate cancer survivors can
perform both polarized and isocaloric threshold training and that both
types of training can lead to comparable eects on endurance capacity.
However, threshold training required less training time on average, thus
cancer survivors with limited time may prefer threshold training.
Disclosure Statement: e authors declare no conict of interest.
860
Muscle wasting and accompanying symptoms in the
SARCO-DETECT study
Lisa Jochem1; Lea Feline Kraack1; Friederike Hilpert1; Ilka Ratjen2;
Friederike Stölzel3; Thore Wul1; Anne Letsch3; Thorsten Schmidt3
1Christian Albrechts University, Kiel, Deutschland
2University Hospital Schleswig-Holstein (UKSH), Kiel, Deutschland
3University Cancer Center Schleswig-Holstein, Kiel, Deutschland
Background: Muscle wasting is a serious condition in cancer patients and
oen accompanied by reduced quality of life and fatigue, also associated
with a reduction of overall survival. e intention of SARCO-DETECT is
to examine interrelations between quality of life, fatigue previous physical
activity and skeletal muscle mass.
Methods: Overall, 109 cancer patients with various hematologic and
oncologic malignancies (63% male; mean age, 67y (SD±11.0)) at the
University Hospital Schleswig-Holstein were asked to ll in three ques-
tionnaires regarding quality of life (EORTC-QLQ C30), fatigue (FACIT-F)
and physical activity (BSA). Skeletal muscle index (SMI) was calculated
using computer tomography (CT) of muscle area around the third lum-
bar vertebrae. First calculations were performed, analyzing associations of
SMI and quality of life, fatigue and prior physical activity using multivari-
able-adjusted regression analysis.
Result: In this sample, 13% of the patients showed a reduced SMI. e
continuous SMI was not signicantly associated with overall quality of
life (ß=0.001, 95% condence interval (CI): 0.000-0.002, p=0.19), fatigue
(ß=0.004, 95% CI: -0.005-0.014, p=0.34) and prior physical activity in the
last 5 years (p=0.95).
Discussion: Unlike many other studies, in this very heterogenous cohort
of cancer patients no signicant associations between SMI, quality of
life, fatigue and prior physical activity could be found in the SARCO-
DETECT sample. Only few patients showed reduced SMI scores though,
thus impeding the nding of associations and underlining the need to
analyze more dened and larger patient subgroups.
Conclusion: In order to being able to detect associations described in the
literature, SARCO-DETECT will be pursued, focusing on patient sub-
groups with reduced SMIs.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 203
946
„Deutsches Kompetenzzentrum Leistungssport und Krebs“–
Professional and interdisciplinary care for competitive
athletes living with and beyond cancer
Nora Zoth1; Axel Heidenreich2; Roman Pster3; Peer Eysel4;
Wolfram Malter5; Sabine Vay6; Jan Werner6; Argiris Vassiliadis7;
Sina Michaelis1; Hans-Georg Predel7; Michael Hallek1; Freerk T. Baumann1
1University Hospital Cologne, Dept. of Internal Medicine I, Centre of Integrated
Oncology Cologne, Cologne, Deutschland
2University Hospital Cologne, Dept. of Urology, Uro-Onology, Root-Assisted and
Specialzed Urologic Surgery, Cologne, Deutschland
3University Hospital Cologne, Dept. of Internal Medicine III, Heart Centre,
Cologne, Deutschland
4University Hospital Cologne, Dept. of Orthopaedics and Trauma Surgery,
Cologne, Deutschland
5University Hospital Cologne, Dept. of Obstetrics and Gynecology, Women‘s
Clinic and Breast Center, Cologne, Deutschland
6University Hospital Cologne, Dept. of Neurology, Faculty of Medicine and
University Hospital Cologne, Cologne, Deutschland
7German Sport University Cologne, Institute for Cardiology and Sports
Medicine, Dept. of Preventive and Rehabilitative Sport Medicine and Exercise
Physiology, Cologne, Deutschland
Background: As a result of improved treatment options and associated
higher survival rates, professional athletes living with and beyond can-
cer are increasingly planning to return to competitive sport. Besides
sport-specic coaching, managing side eects of medical treatment is key
to being able to exercise during cancer treatment. Consequently, there is a
growing need for targeted collaboration between oncology, organ specic
specialists and sports science in the care of high-performance athletes.
Methods: e German Competence Centre for Competitive Sport and
Cancer provides support to high-performance athletes who suer from
cancer during their active career. e core tasks of the centre are counsel-
ling, treatment and care of the aected athletes and their relatives, but also
of the coaches and attending physicians.
Result: Following a comprehensive medical assessment of whether a
return to competitive sport is justiable, the aim is to ensure the fastest
possible and most individualised reintegration into competitive sport.
Training concepts that are individually tailored to the athlete, type of
sport, cancer and medical therapy are essential. ese demands can be
met by a specialist conference e.g. consisting of oncologists, physicians
and sport scientists.
Discussion: Despite convincing evidence and illustrations in relevant
guidelines that physical activity is safe and eective in the context of
cancer, there are no specic recommendations for training concepts in
high-performance athletes. In addition, there is no suitable infrastructure
that enables the bundling of expertise necessary for the care of aected
athletes.
Conclusion: e German Competence Centre for Competitive Sport and
Cancer will bridge the gap between medical and therapeutic professionals,
athletes and the athletes environment. e athlete receives the best pos-
sible care through the involvement of top physicians of whom some have
been top athletes themselves in the past, the reduction of medical side
eects, close cardiological screening and training relevant diagnostics.
Disclosure Statement: e authors declare no conict of interest.
Sarcoma
164
Clinical characteristics of sarcoma patients:a population-
based data analysis ona German clinical cancer registry
Jörg Andreas Müller1; Stefan Delank2; Alexander Zeh2; Ian Wittenberg3,4;
Daniel Medenwald4,5; Dirk Vordermark5
1Universitätsklinikum Halle (Saale), Department für Strahlenmedizin Univ.-Klinik
und Poliklinik für Strahlentherapie Halle (Saale), Deutschland
2Universitätsklinikum, Halle, Department für Orthopädie, Unfall- und
Wiederherstellungschirurgie Halle (Saale), Deutschland
3Klinische Krebsregister Sachsen-Anhalt gGmbH, Magdeburg, Deutschland
4Martin-Luther-Universität Halle-Wittenberg Medizinische Fakultät Institut
für Medizinische Epidemiologie, Biometrie und Informatik, Halle (Saale),
Deutschland
5Universitätsklinikum Halle (Saale), Department für Strahlenmedizin Univ.-Klinik
und Poliklinik für Strahlentherapie, Halle (Saale), Deutschland
Background: Sarcomas are a heterogenous group of malignant neoplasms
with a wide range of histological types and occur in almost any anatomic
side.
Methods: e German clinical cancer register of Saxony-Anhalt was
assessed. Sarcoma cases of all clinical or pathological T-stages (T1a-T4c),
all N-stages (N0-3) and M-stages (0-1b) corresponding to the UICC
stages I to IVB were considered. In our analyses, n=787 cases diagnosed
between 2005 and 2022 were included. Further, we assessed the associa-
tion of cancer-related parameters with mortality, hazard ratios (HR) from
Cox proportional hazards models were computed.
Result: e majority of sarcoma patients was diagnosed with
Leiomyosarcoma (12%), Liposarcoma (11%), Angiosarcoma (5.3%) and
Myxobrosarcoma (2.7%). In our univariate regression models, tumors
localized in more than one location, head, face and neck region as well
as pelvic and lower extremity sarcoma were associated with increased
mortality risk (more than one location: HR: 7.10, 95% CI 2.20-22.9; head,
face and neck: HR: 1.35, 95% CI 0.89-2.06; pelvis: HR: 1.27, 95% CI 0.86-
1.89; lower extremity: HR: 1.44, 95% CI 1.05-1.96). Higher histological
grades, UICC-grades and TNM-stages were related to a higher mortality
risk. Patients diagnosed with bromyxoid sarcoma, rhabdomyosarcoma
and hemangiosarcoma were related to higher mortality risk compared to
other histological subtypes (bromyxoid sarcoma: HR: 5.2, 95% CI 0.71-
38.1; rhabdomyosarcoma: HR: 2.93, 95% CI 1.44-6.00; hemangiosarcoma:
HR: 1.07, 95% CI 0.53-2.18).
Discussion: As a point of criticism of the present study one hast to be
aware that data from a single cancer registry might lead to selection bias.
erefore, prospective analyses should include multiple cancer registries
with patients from dierent social and ethnic backgrounds.
Conclusion: Histological grade, tumor size, nodal and distant metastasis,
tumor localization and histological subtype were determined as prognos-
tic factors in terms of survival.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts204
233
Genitourinary sarcoma in adults: A population-based analysis
of tumor characteristics, incidence and survival in North
Rhine-Westphalia (NRW)
Rainer Hamacher1; Lennart Möller2; Hiltraud Kajüter2; Christine Eisfeld2;
Mohamed Assahub3; Christopher Darr4; Boris Hadaschik4;
Sebastian Bauer1; Andreas Stang2; Viktor Grünwald3
1University Hospital Essen, Department of Medical Oncology, West German
Cancer Center, Essen, Deutschland
2Cancer Registry of North Rhine-Westphalia, Bochum, Deutschland
3University Hospital Essen, Interdisciplinary Genitourinary Oncology at the
West-German Cancer Center, Clinic for Internal Medicine (Tumor Research) and
Clinic for Urology, Essen, Deutschland,
4University Hospital Essen, Department of Urology, Essen, Deutschland
Background: Sarcomas of the genitourinary (GU) tract are rare. We ana-
lyzed the incidence and survival in North Rhine-Westphalia regional can-
cer registry.
Methods: Patients ≥18 years were identied based on ICD-O-3 morphol-
ogy and topography codes. Only ma-lignant tumors (behaviour 3) were
included. Age-standardized incidence rates (ASR) were calculated (old
European Standard). Descriptive statistics were conducted, stratied by
histological subtypes and tumor locations. Kaplan-Meier curves were uti-
lized for survival analyses.
Result: We identied 1,392 incident cases (f/m N=1,102/290) from 2008-
2019. e ASR for GU sarcoma was 0.49/105 (95%-CI 0.46-0.52) with
0.77/105 (95%-CI 0.72-0.82) for females and 0.20/105 (95%-CI 0.18-0.22)
for males. In females, for gender-specic tumors, the majority presented
in the uterus (N=890; 81%), vulva/vagina (N=55; 5%) and ovary (N=40;
4%). e most common histological subtypes were leiomyosarcoma
(N=456; 41%), endometrial stromal sarcoma (N=312; 28%) and adeno-
sarcoma (N=87; 8%). In males the majority presented at the spermatic
cord (N=78; 27%), testis (N=57; 20%) and prostate (N=22; 8%). e most
common histological subtypes in men were liposarcoma (N=111; 38%),
leiomyosarcoma (N=80; 28%) and undierentiated sarcoma (N=21; 7%).
In both sexes, bladder was the most common location in the urinary tract
(f/m=36/39) followed by the kidney (f/m=30/42). Here, the most common
histological subtypes were leiomyosarcoma (N=51; 35%) and liposarcoma
(N=9; 6%). e median overall survival was 69.3 months (95%-CI 56.7-
89.0). In the total cohort, the 5-year survival probability was in females
52% (95%-CI 49-55%) and in males 51% (95%-CI 45-58%).
Discussion: Sarcomas of the GU tract show higher incidence for females
and gender-dependent dierences for histological subtypes. e 5-year
survival probability did not show a gender dierence.
Conclusion: Further analysis have to address the impact of histology and
topography on prognosis.
Disclosure Statement: e authors declare the following: Viktor Grünwald reports
institutional funding with a grant from AstraZeneca for the MEDOSARC study.
All the other authors declare no conict of interest.
255
Transferability of cancer registry data to clinical practice in
retroperitoneal sarcoma
Franziska Neemann1; Lina Jansen2; Christian Silcher1; Bernd Kasper1;
Peter Hohenberger1; Jens Jakob1
1Mannheim University Hospital, Mannheim, Deutschland
2Epidemiological Cancer Registry Baden-Württemberg German Cancer
Research Center (DKFZ), Heidelberg, Deutschland
Background: Retroperitoneal sarcomas (RPS) are a rare, heterogeneous
tumor group for which valid data is needed to guide treatment. To date,
these come from cohorts on general so tissue sarcomas. Cancer registries
(CR) may be another possible source. It is questionable whether patients
recorded in CR are comparable to an expert cohort in patient and tumor
characteristics. is work compares CR and TARPS data to assess the rep-
resentativeness of TARPS and the quality of CR data.
Methods: e TARPS cohort includes patients of primary RPS (years
2002 - 2011) and surgery in specialized centers (1). e CR Baden-
Württemberg cohort includes all patients with primary RPS M0 (years
2016 - 2021, ICD-10 C.49.4/5, C48.x) and surgery within 12 months. To
optimize the non-specic localizations (C48.x), only sarcoma-typical
ICD O codes were chosen (see Onkozert certication). Patient, tumor,
and therapy factors (Chi² Test) and overall survival (Kaplan Meier) were
compared.
Result: A total of 1007 (TARPS) and 319 (CR) patients were included.
Patients in the CR cohort were signicantly older (+9 years), had higher
grading and a dierent histology distribution. e gender distribution,
R status and proportion of patients with chemo- and radiotherapy were
comparable. However, CR patients were less likely to have chemotherapy
or radiotherapy before surgery. e 3-year survival probability was lower
(73%) compared with TARPS (77%).
Discussion: e TARPS data are highly selected due to recruitment in spe-
cialized centers and have high data quality. CR data are population-based
and thus representative of all RPS patients, but data quality is dependent
on completeness and quality of reporting. Dierent codes make it dicult
to compare cohorts.
Conclusion: Overall, the quality of CR data appears sucient to represent
a cohort of RPS patients. It is important to optimize the reporting process
for sarcomas to use the existing data from the nationwide cancer registries
in the future.
Indication of source:
1 doi: 10.1002/cncr.33139.
Disclosure Statement: e authors declare no conict of interest.
324
Recurrent Hematothorax Following Epithelioid Angiosarcoma
of the Pleura
Niels Michael Dörr-Jerat1; Jürgen Knolle2; Claus Jürgen May1;
Sykle Schmidt3; Marcus Krüger1
1Klinik für Thoraxchirurgie, Krankenhaus Martha Maria Halle/Dölau, Halle
(Saale), Deutschland
2Klinik für Pathologie, Krankenhaus Martha Maria Halle/Dölau, Halle (Saale),
Deutschland
3Klinik für Anästhesiologe, Krankenhaus Martha Maria Halle/Dölau, Halle (Saale),
Deutschland
Purpose: We present a case of a female patient with recurrent bilateral
hemothorax. Aer misdiagnosis despite multiple histologic specimens, a
pleural manifestation of epithelioid angiosarcoma was diagnosed by fur-
ther immunohistologic staining. Based on this case we would like to sen-
sitize the reader for this rare disease.
Methods: is is a case report of an extremely rare pathology of the
pleura. About 30 case reports have been published so far. Our experience
is discussed against the background of previous case reports.
Results: A 73-year-old fully conscious woman presented with dyspnea of
3 days’ duration. She was in a stable general condition, without cardiopul-
monary events, not on anticoagulation medication. Physical examination
revealed decreased breath sounds on the le side, hemoglobin was 7.0
mmol/l.
Initial chest x-ray showed a le pleural eusion. A hemothorax was diag-
nosed. Workup showed no evidence of malignancy (CT, EBUS, cytology,
etc.). VATS was performed and biopsies of pleural abnormalities did not
provide congruent ndings of hemothorax. e additional pathologi-
cal report aer further processing revealed an epitheloid angiosarcoma
dened by massively proliferating epitheloid cells strongly positive for
ERG and CD31, negative for CD34.
Discussion: is case highlights the need for good communication
between surgeons and pathologists. Even when biopsies are suitable for
diagnosis, misdiagnosis may occur due to misinterpretation of the clini-
cal course, misunderstanding of tumor localization and cell morphology,
leading to inappropriate immunohistochemical staining programs.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 205
Conclusion: Physicians treating spontaneous hemothorax must have a
broad knowledge of the possible and sometimes rare etiologies. Pleural
angiosarcoma should be considered in the dierential diagnosis of recur-
rent hemothorax.
Disclosure Statement: e authors declare no conict of interest.
686
Health related Quality of Life over time in German sarcoma
patients. - An analysis of associated factors - results of the
PROSa study
Martin Eichler; MSc.1; Leopold Hentschel2; Susanne Singer3; Bernd Kasper4;
Dimosthenis Andreou5; Daniel Pink6; Karin Arndt7; Martin Bornhäuser1;
Jochen Schmitt8; Markus Schuler9
1Universitätsklinkum Dresden, MK1 & NCT/ UCC, Dresden, Deutschland
2Universitätsklinikum Dresden/ NCT/ UCC, Dresden, Deutschland
3Universitätsmedizin Mainz, IMBEI, Mainz, Deutschland
4Universtitätsklinikum Mannheim, Sarkomzentrum, Mannheim, Deutschland
5Medical University of Graz/ Department of Orthopedics and Trauma, Graz,
Österreich
6Helios Hospital Bad Saarow/ Sarcoma Center Berlin-Brandenburg, Bad Saarow,
Deutschland
7Deutsche Sarkomstiftung, Wölfersheim, Deutschland
8Universitätsklinkum Dresden, ZEGV & NCT/ UCC, Dresden, Deutschland
9Universitätsklinkum Dresden, MK1, Dresden, Deutschland
Background: Sarcomas are rare cancers and very heterogeneous in their
location, histological subtype, and treatment. Health-Related Quality of
Life (HRQoL) of sarcoma patients has rarely been investigated in longi-
tudinal studies.
Methods: Here, we assessed adult sarcoma patients and survivors between
September 2017 and February 2020, and followed-up for one year in 39
study centers in Germany. Follow-up time points were 6 (t1) and 12 months
(t2) aer inclusion. We used a standardized, validated questionnaire (the
European Organisation for Research and Treatment of Cancer Quality
of Life Core Instrument (EORTC QLQ-C30) and explored predictors of
HRQoL in two populations (all patients (Analysis 1), patients in ongoing
complete remission (Analysis 2)) using generalized linear mixed models.
Result: In total we included up to 1111 patients at baseline (915 at t1, and
847 at t2), thereof 387 participants were in complete remission at baseline
(334 at t1, and 200 at t2). When analyzing all patients, HRQoL diered
with regard to tumor locations: patients with sarcoma in lower extrem-
ities reported lower HRQoL values than patients with sarcomas in the
upper extremities. Treatment which included radiotherapy and/ or sys-
temic therapy was associated with lower HRQoL. For patients in complete
remission, smoking was associated with worse HRQoL-outcomes. In both
analyses, bone sarcomas were associated with the worst HRQoL values.
Being female, in the age group 55-<65 years, having lower socioeconomic
status, and comorbidities were all associated with a lower HRQoL, in both
analyses. HRQoL increased partially over time since treatment and with
sporting activities.
Discussion: HRQoL improved with time since treatment, although not in
all domains, and was associated with lifestyle and socioeconomic factors.
Bone sarcomas were the most aected subgroup.
Conclusion: Methods to preserve and improve HRQoL should be devel-
oped for sarcoma patients.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
821
Proton Therapy in Patients with Parameningeal Soft Tissue
Sarcoma – Results of the Prospective Registry Studies ProReg
and KiProReg
Beate Timmermann1; Christine Hansel2; Dalia Ahmad Khalil2; Yi-Lan Lin2;
Monika Sparber-Sauer3; Xavier Vermeren2; Christoph Blase4;
Stephan Tippelt5; Sebastian Bauer6; Rolf-Dieter Kortmann2
1Klinik für Partikeltherapie, Universitätsmedizin Essen, Westdeutsches
Protonentherapiezentrum Essen (WPE), Westdeutsches Tumorzentrum (WTZ),
Deutsches Konsortium für Translationale Krebsforschung (DKTK), Deutschland,
Essen, Deutschland
2Klinik für Partikeltherapie, Universitätsmedizin Essen, Westdeutsches
Protonentherapiezentrum Essen (WPE), Westdeutsches Tumorzentrum (WTZ),
Deutschland, Essen, Deutschland
3Klinikum der Landeshauptstadt Stuttgart GKAöR, Olgahospital, Stuttgart
Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pädiatrie 5
(Pädiatrische Onkologie, Hämatologie, Immunologie), Medizinische Fakultät,
University of Tübingen, Stuttgart, Deutschland
4AnästhesieNetz Rhein-Ruhr, Bochum, Deutschland, Bochum, Deutschland
5Universitätsmedizin Essen, Kinderklinik III, Pädiatrische Hämatologie und
Onkologie, Westdeutsches Tumorzentrum (WTZ), Essen, Deutschland, Essen,
Deutschland
6Innere Klinik (Tumorforschung), Universitätsmedizin Essen, Westdeutsches
Tumorzentrum (WTZ), Sarkomzentrum Essen, Deutschland, Essen, Deutschland
Background: Proton therapy (PT) is an important therapy for patients
with parameningeal so tissue sarcomas (PM-STS). PT delivers a unique
dose distribution and therefore spares organs at risk limiting risks for
adverse events. We analyzed the outcome of patients with PM-STS.
Methods: Patients treated from January 2014 - July 2023 for PM-STS
and enrolled to our in-house registry studies KiProReg and ProReg were
included in this analysis. Data on patient and tumor characteristics, ther-
apy and adverse events (according to CTCAEv4/5) was evaluated.
Result: 93 patients (90 children, 3 adults) met inclusion criteria (51 m,
42 f; median age 7.1 yrs, range 1.1-50.4). 89 patients were diagnosed with
rhabdomyosarcoma. All patients underwent chemotherapy prior to PT;
79 patients concurrent to PT. ree patients received previous radiother-
apy within the same radiation area. Complete resection before PT was
achieved in nine patients. All patients were treated at the primary tumor
site. PT was delivered in adjuvant (29.0%) or denitive (71.0%) setting.
Median dose of PT was 55.8 Gy (range 40.0-59.4 Gy), delivered in 31 frac-
tions (range 16-33 fractions). Median FU time was 2.3 yrs. (range 0.4-12.9
yrs.). Tumor control was achieved in 67 patients. 16 patients developed
local progression; ten patients developed dissemination. Four patients
were treated with a second course of PT at relapse. 16 patients died. ree-
year overall survival, progression free survival and local control were 79%,
63% and 71%, respectively. Acute higher grade (>grade 2) toxicities con-
cerned fatigue or pain (n=2), dermatitis (n=5) and blood (n=21; anemia,
leukopenia, neutropenia or thrombopenia), during PT. Long term higher
grade toxicities concerned dermatitis (n=1), oral mucositis (n=1), blood
(n=1), neoplasm (n=1 Leukemia), skin and subcutaneous tissue (n=3),
eye disorders (n=8; cataract, conjunctivitis, optic nerve disorder, vision
decrease) and others (n=1).
Conclusion: PT seems safe and eective in patients with PM-STS. Results
have to be conrmed in a longer FU.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts206
Skin Cancer including Melanoma
561
Preliminary ndings from a phase II study show promising
results in overcoming primary resistance to checkpoint
inhibitors among patients with advanced melanoma using
intermittent alkylating chemotherapy
Lucie Heinzerling1; Sebastian Haferkamp2; Bastian Schilling3;
Carola Berking4; Edward Geissler5; Florian Zeman6
1Klinik und Poliklinik für Dermatologie und Allergologie der LMU München,
München, Deutschland
2Universitätsklinikum Regensburg, Klinik und Poliklinik für Dermatologie,
Regensburg, Deutschland
3Hautklinik - Uniklinikum Würzburg, Würzburg, Deutschland
4Hautklinik des Uni-Klinikums Erlangen, Erlangen, Deutschland
5Universitätsklinikum Regensburg, Experimentelle Chirurgie, Regensburg,
Deutschland
6Universitätsklinikum Regensburg, Zentrum für klinische Studien,
Regensburg, Deutschland
Background: Patients with BRAF wildtype (wt) metastatic melanoma with
primary resistance to immune checkpoint inhibitors (ICI) have an appall-
ing prognosis. Chemotherapy has been shown to alter factors that inuence
response to ICI like genetic mutations, tumor microenvironment, microbi-
ome and immune system. is phase II trial investigates whether two doses
of an alkylating agent called dacarbazine (DTIC) can render patients with
primary resistance to ICI responsive to the same ICI treatment.
Methods: Within the study, 39 patients are included at four skin cancer
centers. Patients receive two doses of DTIC (850 mg/m2 i.v.) on days 1
and 21, followed by re-exposure to the same ICI therapy they had previ-
ously shown resistance to. Using a two-step design, the expected response
rate was set at 20%, with an uninteresting response rate of 5% (one-sided
alpha of 5% and 90% power). Response was dened as complete or partial
response by week 14.
Result: At interim analysis, 29 patients were evaluable for the primary
endpoint of tumor response according to RECIST 1.1. e overall response
rate was 24% (90% CI: 12-41%), with seven out of 29 patients showing a
partial response. e disease control rate was 38% (11 out of 29 patients).
e treatment was well tolerated, with 16% of patients experiencing grade
3 or higher adverse events and no new safety signals.
Discussion: Short-term chemotherapy can break resistance to ICI ther-
apy in a subgroup of patients. is nding is signicant as this treatment
approach could be easily translated into clinical practice. Investigation of
longitudinal biological samples (serum, plasma, PBMC, tissue and stool
samples) will provide further insights into the mechanisms associated
with rendering patients responsive.
Conclusion: e administration of two doses of DTIC can break ICI resis-
tance in patients with metastatic melanoma. is observation justies the
continuation of this phase II trial to assess eectiveness and mechanisms
of this approach. e enrollment is ongoing. Clinical trial: NCT04225390.
Sponsor: German Cancer Aid; University hospitals.
Disclosure Statement: e authors declare that there are conicts of interest.
econicts were submitted to the congress organizer KUKM GmbH and KUKM
can disclose them if needed.
Supportive Care
17
Reasons for encounter and recommended complementary
and integrative health care measures in cancer patients –
results of the implementation study CCC-Integrativ”
Andreas Schmitt1; Stefanie Joos1; Cornelia Mahler2; Regina Stolz1;
Holger Mauch1; Jan Valentini1
1Institute for General Practice and Interprofessional Care, University Hospital
and Faculty of Medicine Tuebingen, Tuebingen, Deutschland
2Department of Nursing Science, Institute for Health Sciences, University
Hospital and Faculty of Medicine Tuebingen, Tuebingen, Deutschland
Background: Complementary and integrative healthcare (CIH) is becom-
ing more common as a complement to conventional cancer treatment.
We conducted a controlled interprofessional implementation study with
n=1,128 oncology patients (CO=443, IG=685) at four Comprehensive
Cancer Centers in BW, Germany. is abstract analyzes which reasons for
encounter (RfE) led to which CIH interventions within the study.
Methods: Prior to the study, we dened 20 common symptoms of cancer
patients, for which we evaluated evidence-based CIH measures in a multi-
stage procedure. Every patient received three consultations and a counseling
letter aer each consultation. e data of the letters were analyzed using quali-
tative content analysis. e RfE were categorized by the ICPC-3-classication.
Results: 1809 counseling letters of 603 patients were included. A total of
4397 RfE were documented (7/patient). Fatigue was most common (56%),
followed by digestive complaints (51%), general complementary medicine
issues (44%), polyneuropathy (41%), mucosal problems (40%) and others.
A total of 8342 CIH measures were recommended (14/patient). Nearly
all patients received recommendations on non-medical procedures (98%)
and on external applications (92%), a majority on phytotherapeutics or
tees (79%) and acupressure (79%). Recommendations on non-medical
procedures included nutritional counseling (94%), exercise (92%) and
relaxation techniques (80%).
Discussion: Interprofessional evidence-based CIH counseling covers a
wide range of cancer patients’ concerns and complaints. Recommended
measures range from life-style recommendations (exercise, diet,
relaxation) to specic CIH applications like acupressure, external appli-
cations, phytotherapeutics and others. Within the CCC-Integrativ study,
we were able to show that a variety of methods from dierent medical
systems can be used for a variety of specic RfE.
Conclusion: Our counseling was tailored according to the best available
evidence and integrates both medical and nursing aspects in an overarch-
ing counseling concept.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 207
35
Results of the module nutrition in the CARE for CAYA
program – a need-based multimodal lifestyle survivorship
program focusing on physical activity, nutritional behavior
and psychological processes in survivors of cancer
inchildhood, adolescence and young adulthood
Julia von Grundherr1; Simon Elmers1; Luisa Samland1; Raika Mühlberg1;
Gabriele Calaminus2; Sonja Schuster3; Annette Sander4; Alexander Puzik5;
Inken Hilgendorf6; Judith Gebauer7; Michael Köhler8; Jörg Faber9;
Nicole Salzmann10; Magdalena Sokalska-Duhme11; Claudia Metz12;
Lisa Schimann13; Luzia Valentini14; Freerk T. Baumann15; Eik Vettorazzi16;
Jannike Salchow1; Sarah Dwinger17; Alexander Stein1;
Carsten Bokemeyer1; Marianne Sinn1
1Department of Oncology, Hematology, BMT with Section Pneumology,
Hubertus Wald Tumor Center - University Cancer Center Hamburg, University
Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2Department of Pediatric Hematology and Oncology, University Hospital Bonn,
Venusberg Campus 1, Bonn, Deutschland
3Abteilung für pädiatrische Hämatologie und Onkologie, Kinder- und
Jugendklinik, Universitätsklinikum Erlangen, Erlangen, Deutschland
4Medizinische Hochschule Hannover, Klinik für Pädiatrische
Hämatologie-Onkologie, Hannover, Deutschland
5Department of Pediatric Hematology and Oncology, Medical
Center - University of Freiburg, Faculty of Medicine, University of Freiburg,
Freiburg, Deutschland
6Klinik für Innere Medizin II, Abteilung für Hämatologie und Internistische
Onkologie, Universitätsklinikum Jena, Jena, Deutschland
7Department of Internal Medicine I, University Hospital of Schleswig-Holstein,
Campus Luebeck, Lübeck, Deutschland
8Department of Hematology and Oncology, University Hospital Magdeburg,
Magdeburg, Deutschland
9Department of Pediatric Hematology/Oncology, Center for Pediatric and
Adolescent Medicine – University Cancer Center, (UCT), University Medical Center
of the Johannes Gutenberg-University Mainz, Mainz, Deutschland
10University Children‘s Hospital Muenster, Pediatric Hematology and Oncology,
Münster, Deutschland
11Department of Pediatric Hematology, Onkology & Immunology, Olgahospital,
Klinikum Stuttgart, Stuttgart, Deutschland
12Clinic for Pediatrics III, Department of Pediatric Hematology/Oncology, West
German Cancer Centre, University Hospital, Essen, Essen, Deutschland
13Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-Universität
Würzburg, Würzburg, Germany CCC WERA, University Hospital Würzburg,
Würzburg, Deutschland
14University of Applied Sciences, Faculty of Agriculture and Food Sciences,
Neubrandenburg, Deutschland
15Department I of Internal Medicine, Center for Integrated Oncology
Aachen Bonn Cologne Dusseldorf, University Hospital, of Cologne, Cologne,
Deutschland
16Institute for medical Biometry and Epidemiology, Hamburg, Deutschland
17Department for Medical Psychology, University Medical Center
Hamburg-Eppendorf, Hamburg, Deutschland
Background: Children, adolescents and young adult cancer survivors
(CAYAs) are oen aected by late and long-term eects. Studies have shown
that a healthy diet and weight can lower the risk of secondary diseases. e
module nutrition of the CARE for CAYA program (CFC-P) was designed to
reduce the need for nutritional interventions among CAYAs.
Methods: An initial RCT compared need-based modular interventions to
usual care for CAYAs aged 15–39 years in 14 German clinics (December
2017–July 2020). A comprehensive assessment was conducted to identify
needs in nutrition, physical activity and psycho-oncology (T1). If a ‘high
need’ was identied in Nutrition, the intervention group (IG) received ve
counselling sessions and the control group (CG) one. Primary outcome
was changes in the dietary quality aer 52 weeks (T3) measured with
Healthy Eating Index (HEI-EPIC) in points (pts) based on 3-day dietary
records (classication in good ≥ 65 pts, moderate > 40–65 pts or poor
≤ 40 pts dietary quality). Secondary outcomes were e.g. mediterranean
dietary quality (MEDAS-FFQ), fatigue (EORTC-C30) and quality of life
(EORTC-C30).
Results: A total of 357 CAYAs participated in the RCT, 63.0% were female
and median age was 25.0 years.
Aer 52 weeks, the ‘high need’ in Nutrition decreased in both groups,
from 75.2% to 71.8% in the IG and from 77.9% to 67.3% in the CG. Due
to the study design, modular endpoints were assessed on an exploratory
basis. Regarding the primary outcome dietary quality, median HEI-
EPIC score improved aer 52 weeks in both groups, in IG (T1=48.0 pts;
T3=52.0 pts) and in CG (T1=48.0 pts; T3=51.5 pts). us, ‘high need
criteria poor dietary quality improved from 27.1% to 14.9%. Concerning
secondary endpoints, improvements in mediterranean dietary quality as
well as fatigue and quality of life scores were observed in both groups.
Conclusion: e CFC-P showed a high need for nutritional support
among the CAYAs. Dietary quality was moderate and should be improved,
the HEI-EPIC score improved slightly aer 52 weeks. It seems reasonable
to provide at least one nutritional counseling.
Disclosure Statement: e authors declare the following: AOK Germany, Astra
Zeneca, Bayer Healthcare, BioNTech, Bristol Myers Squipp, Jansen Cilag, med
update, Merck Serono, On-cology Drug Consult CRO, Roche Pharma, Sano
Aventis, Hamburg Cancer Society, National Network of German Cancer Cen-ters,
Northern German Society of Internal Medicine, DGHO, BeiGene, Janssen-
Ciliag, medac, Celgene, JazzPharmazeuticals, Fondazione Internationale Menarini,
BMS, MSD, Incyte, Pzer, Servier, Amgen, Incyte, Pierre Fabre, Biegene, AbbVie,
Novartis.
80
Building a nationwide safety net for oral antitumor therapy:
SafetyFIRST - a cluster-randomized stepped-wedge trial
Julia Schwanfelder1,2; Katja Schlichtig2; Lars Wismar3; Christian Staerk4;
Andreas Mayr4; Martin F. Fromm2; Ulrich Jaehde3; Frank Dörje1
1Pharmacy Department, Erlangen University Hospital, Erlangen, Deutschland
2Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-
Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Deutschland
3Department of Clinical Pharmacy, Institute of Pharmacy, Rheinische Friedrich-
Wilhelms-Universität Bonn, Bonn, Deutschland
4Institute of Medical Biometry, Informatics and Epidemiology, University
Hospital Bonn, Bonn, Deutschland
Background: Several challenges in the use of oral antitumor therapies
(OAT) require close patient and medication management. e AMBORA-
trial1 demonstrated considerable benets of an intensied clinical phar-
macological/pharmaceutical care program in patients with various tumor
types: Less medication errors and (severe) adverse events were observed
and patient perception improved. Safety-FIRST aims to assess the trans-
ferability and ecacy of this program in a nationwide setting with heter-
ogenous care settings.
Methods: A SafetyFIRST competence center was established to train 24
interprofessional tandems comprising community/ hospital pharmacies
and oncology ambulatory clinics/ practices. Using a cluster-randomized
trial with a stepped-wedge design, the study will evaluate standard versus
the intensied interprofessional care with at least 600 patients. e pri-
mary outcome is a combined endpoint of severe adverse events (CTCAE
≥3), treatment discontinuation, unscheduled hospital admission, and
death, in accordance with one AMBORA-trial’s endpoint1.
Result: 24 participating tandems were successfully recruited. A workshop
with around 70 attendees addressed healthcare professionals’ roles, scien-
tic evaluation, and strategies to overcome implementation barriers. e
results were considered for generation of the nal study protocol. Patient
recruitment will begin in January 2024, accompanied with a status quo
survey on interprofessional collaboration within the tandems.
Discussion: In a nationwide approach, SafetyFIRST aims to enhance
medication safety, strengthen patient competence, and improve interpro-
fessional collaboration. Upon data completion, the ndings will be used
for potential integration of the intervention into routine medical care to
ensure sustainable benets.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts208
Conclusion: SafetyFIRST represents a promising step forward in enhanc-
ing patient safety in OAT through an intensied interprofessional care
program in heterogenous care settings.
1 Dürr P, Schlichtig K, Kelz C, et al. J Clin Oncol 2021, 39: 1983–1994.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
143
Physical activity in people with lung cancer during systemic
antitumor therapy in an oncology day-clinic initiated by
nurses - development of a person-centered physical activity
concept with patient participation
Ramona Engst1; Andrea Kobleder1; Joachim Wiskemann2; Nicola Greco3;
Anastasios Manettas3,4; Steen Heinrich1; Caroline Tanner5; Antje Koller1
1Eastern Switzerland University of Applied Sciences, Departement of Health,
Institute of Applied Nursing Science, St. Gallen, Schweiz
2National Center for Tumor Diseases (NCT) Heidelberg, Department of Medical
Oncology, Heidelberg, Deutschland
3University Hospital, Department of Physiotherapy and Occupational Therapy
(PEU), Zurich, Schweiz
4University of Thessaly, Department of Physical Education and Sport Science,
Biomechanics and Ergonomics, ErgoMech Laboratory, Trikala, Griechenland
5Eastern Switzerland University of Applied Sciences, Departement of Health,
BSc Physiotherapy, St. Gallen, Deutschland
Purpose: Physical activity is eective in reducing side eects and increasing
well-being in lung cancer patients. However, there is no systematic approach
to promote physical activity during the stay in oncology day clinics before,
during and aer therapy. erefore, the aim of this project is to develop an
evidence-based physical activity concept for people with lung cancer in the
oncology outpatient day-clinic. It is designed to be supervised by nursing
sta to be realized by the cancer patients themselves.
Methods: An interprofessional expert panel (n=15) was engaged over 7
months (2022/23) in three rounds based on the delphi method to select
evidence-based activities for people with lung cancer potentially and
safely applicable by oncology nurses and the interprofessional team.
Result: According to the experts, the nurse-led physical activity concept
for an oncology outpatient day-clinic is based on ve core components:
(1) team approach, (2) activities in a modular structure, (3) person-
centeredness, (4) a safety-, and (5) a communication-concept.
(1) Team approach: Each person in the interprofessional team contrib-
utes with their unique role in routine care
(2) ree modules (Mds): Md1 - mild activities for everyone. Md2 - mild
intensity exercises selected and performed with the nurses. Md3 -
referrals to indication-based professionally guided training
(3) Person-centeredness: Wishes, experiences and potentials of individ-
ual patients are assessed and integrated
(4) e safety concept includes contra-indications, hygiene, injury avoid-
ance and other
(5) e communication concept enables teams to act in concert
Discussion: e expert discussion has shown that a catalogue with exer-
cises alone is not sucient, but that ve core components are central to a
physical activity concept. While the ve components are mandatory, the
concept remains exible and adaptable, by providing guidance on local
individual adjustments for each component.
Conclusion: In a next step the eectiveness of the program and impact on
lung cancer patients’ outcomes will be tested.
Disclosure Statement: e authors declare no conict of interest.
145
Implementation of regular lifestyle counseling during
long-term follow up care of childhood cancer survivors
Franziska Richter1; Lea Kronziel2; Inke König2; Thorsten Langer1;
Judith Gebauer3
1Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Kinder-
und Jugendmedizin, Pädiatrische Onkologie und Hämatologie, Lübeck,
Deutschland
2Universität zu Lübeck, Institut für Medizinische Biometrie und Statistik,
Lübeck, Deutschland
3Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Medizinische Klinik I,
Leitung Interdisziplinäre Langzeitnachsorge, Lübeck, Deutschland
Background: Many childhood cancer survivors (CCS) develop treat-
ment-related late eects, including increased risk of obesity and metabolic
syndrome. A healthy lifestyle can reduce the risk of associated comorbidi-
ties. erefore, at-risk CCS could benet from lifestyle counseling during
regular long term follow up (LTFU).
Methods: Lifestyle counseling was implemented within LTFU care over
the study period of one year. Metabolic markers and activity levels were
prospectively evaluated as screening parameters for dierent risk groups.
Perspectives of CCS, physician and sports scientist were compared to
identify those CCS with the highest need of counseling. A follow-up
appointment aer one month was performed.
Result: During LTFU care, 155 CCS (65% female, 35% male) aged between
18 and 63 years (median:30 years) were contacted. 112 CCS (72%) had an
indication for lifestyle counseling based on assessments from physicians,
sports scientists, or themselves. Among them, 45% were aected by meta-
bolic disorders and 46% did not meet the recommended activity levels. A
total of 120 CCS (77%) received lifestyle counseling, including 8 CCS who
initially did not desire a counseling, but were open for recommendations.
ose who underwent intensive cancer treatment showed the highest
need. During follow-up, CCS indicated high adherence to recommenda-
tions and successful implementation into their daily lives. Nearly all sur-
vivors (97%) found the provision of lifestyle counseling during regular
LTFU benecial.
Discussion: Prediabetic conditions aected 19% of CCS, with 6% bene-
ting despite not meeting criteria. Due to limited resources, its crucial to
deliberate on the inclusion criteria for lifestyle counseling.
Conclusion: Incorporating specialized healthcare professionals into sur-
vivorship care enhances the multidisciplinary approach and can aid in
promoting a healthy lifestyle, potentially reducing long-term morbidity
among CCS.
Disclosure Statement: e authors declare no conict of interest.
247
Needs analysis of oncological patients with taste
disorders - an interim analysis of the TASTE Guide study
Raika Mühlberg1; Julia von Grundherr1; Luisa Samland1; Lena Pro2;
Carsten Bokemeyer1; Martin Schönlein1; Anne Overlach1; Jennifer
Hagemann1; Marianne Sinn1
1Department of Oncology, Hematology, BMT with Section Pneumology,
Hubertus Wald Tumor Center - University Cancer Center Hamburg, University
Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2Hamburg University of Applied Sciences (HAW Hamburg), Hamburg,
Deutschland
Purpose: erapy-associated taste disorders and hence nutritional behav-
ior is a common and due to malnutrition a clinically relevant problem in
oncological patients undergoing systemic therapy. Up to 2/3 of patients
are described to have changes in the taste perception. e aim of this study
is to identify patients’ needs for support and to improve nurses’ knowledge
of nutrition and taste disorders in oncology patients; and enable them to
provide initial information. Training of nurses will start in October 2023.
Methods: e study is divided into 1) a training of nursing sta and 2)
a survey with out- and inpatients to determine the need for support and
risk of malnutrition. e applied one-time survey consists of a needs
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 209
assessment for side eects (self-developed), an assessment of the risk for
malnutrition and side eects (PG-SGA short form), assessment of taste
and smell perception (medical history form by Prof. Hummel) and inter-
est in nutritional counseling.
Results: e TASTE Guide trial currently has enrolled 100 patients (65%
inpatients, 60% female, median age was 58 years (20-86 years)). e most
common tumor entities were gynecologic tumors (n=34), multiple mye-
loma (n=16) and gastrointestinal tumors (n=11). 73% received a chemo-
therapy, 18% radiation therapy and 28% surgery. Until August 2023, smell
and taste disorders were reported by 35% of patients and 19% specically
reported taste disorders. e mostly self-reported other therapy-associ-
ated side eects were: fatigue (28%), nausea (28%) and loss of appetite
(20%). In the PG-SGA survey at baseline assessment, 31% of patients had
a high risk of malnutrition, 34% a moderate risk, 24% a low risk, and 10%
no risk. Furthermore, 43% of patients expressed interest in receiving a
nutritional counseling.
Conclusion: e side eects are varied; a large proportion of patients
have a risk for malnutrition and reported small and taste disorders. e
expressed need for nutrition counselling was high among these patients.
Disclosure Statement: e authors declare no conict of interest.
327
SOCOFIN - A Digital Study on the Assessment of Financial
Toxicity as a Result of Radiotherapy
Anna Luisa Kreuser1; Rami El Shae1; Oliver Rick2; Sonia Ziegler1;
Thomas Asendorf3; Friederike Braulke4; Stefan Rieken1;
Stephanie Bendrich1; David Alexander Ziegler1; Jan Oelmann1;
Manuel Guhlich1; Martin Leu1; Leif Hendrik Dröge1; Laura Anna Fischer4;
Jann Fischer4; Charlotta Friederike Pagel1
1Universitätsmedizin Göttingen, Göttingen, Deutschland
2Klinik Reinhardshöhe, Bad Wildungen, Deutschland
3Institut für Medizinische Statistik - UMG, Göttingen, Deutschland
4UniversitätsKrebszentrum Göttingen, Göttingen, Deutschland
Background: Financial burden associated with cancer treatment has
become a signicant concern for patients. It may include loss of income
and other out-of-pocket expenses, leading to “nancial toxicity” (FT).
Studies have shown that FT not only adversely aects quality of life1
but also correlates with higher mortality rates2. Interestingly, it can be
detected in patients both without and with health insurance3. However,
limited research is available in European countries, particularly Germany,
a state with public health insurance.
Methods: e rst-time longitudinal exploratory study will assess FT
(COST-12) of patients undergoing radiotherapy in Germany at baseline,
at the end of radiotherapy and three months aerwards. Risk factors and
secondary outcomes include socio-economic factors, health-related qual-
ity of life (EORTC QLQ-C30), depression (PHQ-9), coping mechanisms,
and sense of coherence (SOC Scale). e ocial start of the study is July
6th, 2023, with the aim to enroll about 300 patients. Data is collected using
an electronic case report form, RedCap, both based on RedCap online
surveys and a new mobile app, Patienta.
Result: e primary analysis involves the full analysis set of all patients
with complete primary and secondary outcome. Linear regression is used
to assess the relation between primary and secondary outcomes. Interim
analysis is planned when 75 patients have completed the surveys.
Discussion: e study aims to bridge the knowledge gap on FT of patients
undergoing radiotherapy in Germany. By identifying risk factors, the
impact on quality of life as well as treatment outcomes, the study will con-
tribute valuable insights to address FT in cancer care.
Conclusion: is longitudinal study on FT of patients undergoing
radiotherapy will provide data to further understand FT. e results will
contribute to identify the necessity of strategies to alleviate FT faced by
patients during cancer treatment aiming at improving overall outcomes
and treatment adherence.
Disclosure Statement: e authors declare no conict of interest.
333
Physical Activity as a Treatment for Cancer-Related Fatigue in
Children, Adolescents and Young Adults: A Systematic Review
Mareike Kühn1; Lena Wypyrsczyk1; Sandra Stössel1; Marie A. Neu1;
Lisa Ploch1; Elias Dreismickenbecker1; Perikles Simon2; Jörg Faber1
1Universitätsmedizin Mainz, Klinik und Poliklinik für Kinder- und
Jugendmedizin, Schwerpunktbereich Pädiatrische Hämatologie/ Onkologie/
Hämostaseologie, Mainz, Deutschland
2Institute of Sport Science, Department Sport Medicine, Rehabilitation and
Disease Prevention Johannes Gutenberg University, Mainz, Deutschland
Background: Cancer-related fatigue (CRF) is one of the most common
and distressing symptoms in pediatric oncology. Based on previous stud-
ies, physical activity interventions are considered eective in reducing
CRF in adult cancer patients. However, few studies have investigated the
eect of exercise interventions on CRF in pediatric oncology. e aim of
this systematic review is to investigate whether physical activity interven-
tions can reduce CRF in pediatric patients undergoing cancer treatment.
Methods: A systematic literature search was conducted in PubMed and Sport-
Discus in October 2021 to identify intervention studies examining the eects
of physical activity on CRF in cancer patients’ under 21 years of age. eir
methodological quality was assessed using the JBI Critical Appraisal Tool.
Result: A total of 20 studies (seven randomized controlled trials, six quasi-ex-
perimental studies and seven single-arm intervention studies) were included
in the review. Nine studies reported signicant positive eects of physical
activity interventions on CRF in-group comparison or within groups in child-
hood cancer patients. Eleven trials reported no signicant changes in CRF.
Discussion: e relevance of promoting physical activity as a therapeutic
measure in oncology has been demonstrated by the extensive discussion
of physical activity in oncology and its presence in the current literature.
Regardless of the type of exercise intervention oered, positive eects of phys-
ical activity on CRF and other health-related outcomes are evident. However,
the study situation in the eld of pediatric oncology is very heterogeneous and
shows a wide range with regard to quantitative data on exercise normative.
Conclusion: Physical activity as a therapeutic intervention in pediatric
oncology may have the potential to reduce CRF in childhood cancer
patients undergoing cancer treatment. Further high-quality studies with
large samples are needed to verify these ndings and to assess the interde-
pendence of dose and response of physical activity interventions.
Disclosure Statement: e authors declare no conict of interest.
381
Enhanced screening in geriatric cancer patients-Inclusion
ofsymptom burden as a distressing factor
Lea Büthe; Judith Büntzel
Universitätsmedizin Göttingen, Göttingen, Deutschland
Background: A previous geriatric screen (G8 screening tool) in hematoon-
cological inpatients (HP) showed that a large proportion of HP were identi-
ed as at risk. In this pilot cohort mainly items of nutrition screened positive.
Considering malnutrition is relevant for prognosis and toxicities in elderly
HP, there is a need for a more extensive screening tool to assess not only
malnutrition, but also for contributing factors like symptom burden (SB).
Methods: Elderly HP (> 65 a) at a single center were routinely screened
using the validated screening tools „G8“ and „NRS2002“ in combina-
tion with items addressing SB and dietary changes. Microso excel and
GraphPad Prism were used for data management and statistical analysis
(Students unpaired t-test, Fishers exact test).
Result: No signicant dierence in BMI was detected between age groups
(age < 75 a; age ≥ 75 a; p= 0.07). Overall, 154/201 (77%) HP were positive
in prescreen (NRS2002); of those 141/154 (92.0%) HP were diagnosed with
malnutrition. Concerning Symptom burden, most HP suered from xeros-
tomia (59%; 119/201), loss of appetite (41%; 82/201), constipation (28%;
56/201), loss of taste (28%; 56/201), bloating (27%; 54/201) or nausea (24%;
48/201). ere was a signicantly higher frequency (p=0.02) of dental pros-
thesis provision and associated problems in patients with solid tumors.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts210
Discussion: e reasons of malnutrition are manifold. However, there
are recurring symptoms both in solid and hematological cancer patients.
Xerostomia in particular is an underestimated stress factor. Patients with
solid tumors were more likely to have problematic dental restorations and
were signicantly more likely to have complaints with their teeth.
Conclusion: Malnutrition is still an underestimated problem in older HP.
e application of our modied screening tool does not only capture mal-
nutrition itself but also underlying causes (diet changes, SB). Especially SB
should be considered when optimizing supportive care in HP.
Disclosure Statement: e authors declare no conict of interest.
444
Patients’ perceived competencies in dealing with
disease-related challenges up to one year after acute
treatment of breast or gynecological cancer
Natascha Fahmer1; Hermann Faller1; Achim Wöckel2; Jessica Salmen2;
Peter Heuschmann1,2; Karin Meng1,2
1Julius‐Maximilians‐Universität Würzburg, Würzburg, Deutschland
2Universitätsklinikum Würzburg, Würzburg, Deutschland
Background: Our study aims to investigate patient competencies to deal
with disease-related challenges across the disease course. As a framework,
we assumed that patient competencies reect an interplay of personal
skills/abilities and situational demands.
Methods: We surveyed 100 patients (breast, cervical, endometrial, or
ovarian cancer) and three measurement occasions (t1-t3; acute treatment,
6- and 12-month follow-up). To assess challenges, competencies, and sup-
portive care needs, we used a self-developed questionnaire that comprises
25 items referring to coping tasks assigned to six domains, e.g., informa-
tion, physical complaints, health behavior, psychological distress (1). We
analyzed data, calculating frequencies, percentages, and cross-tabulations
with ‘challenges’ (‘moderate/very much’) and ‘competencies’ (‘yes/no’).
Result: e most common challenges with at least moderate severity (at
least 50%; t1 to t3) lie in coping with psychological distress (e.g., dealing
with fears and insecurities) and in dealing with physical complaints (e.g.,
dealing with reduced capacity). e proportion of women with subjectively
experienced competence in dealing with these individually relevant chal-
lenges is between 43% and 75% during acute treatment. ese proportions
increase throughout the disease for most challenges (t3: 52 to 88%).
Discussion: e results illustrate the diversity and the change in individ-
ual disease-related challenges, perceived competencies, and support needs
up to one year aer the acute treatment.
Conclusion: Oers to strengthen patients’ coping skills should exist longer
term and be accessible according to individual needs. Patient competence
can be promoted through several components. However, empowerment
and patient-oriented care are essential.
Indication of source:
1 Fahmer, N., Faller, H., Wöckel, A., Salmen, J., Heuschmann, P. & Meng, K.
(2023). Patients’ perceived challenges, competencies, and supportive care
needs during acute clinical treatment of breast or gynecological cancer.
Psychooncology, 32, 682–691.
Disclosure Statement: e authors declare no conict of interest.
458
Is spirituality a resource for cancer patients?
Sebastian Ruhe1,2; Helmut Orawa3; Jutta Hübner2; Jens Büntzel1
1Südharz Klinikum Nordhausen, Klinik für Hals-Nasen-Ohrenheilkunde,
Nordhausen, Deutschland
2Universitätsklinikum Jena, Klinik für Innere Medizin II, Am Klinikum 1, Jena,
Deutschland
3Universitätsklinikum Jena, Institut für Medizinische Statistik, Informatik und
Datenwissenschaften, Jena, Deutschland
Background: Religiosity and hidden spirituality are important for over-
coming challenges in life. Until now spiritual care (SpC) is limited for pal-
liative practice. Is it a resource for cancer patients too?
Methods: We asked cancer patients via questionnaire for demograc data,
and to report about follwing issues: spiritual needs (SpNQ-20), self cat-
egorization of spirituality/religiosity, awe and gratitude (GrAw-7), subje-
tive well being (WHO-5), general self-ecacy (ASKU), life satisfaction
(L1-scale), lay etiology concepts, CAM use, ability to change (PIAC scale).
Via SPSS we used following methods for statistical analysis – U-test for
comparing dierences between groups, Spearmen correlations for descrip-
tions of relationships between dependent factors, the Welch test for com-
paring our study population with reference data, mediation analysis for
describing the impact of spirituality on CAM use.
Result: We included 108 patients (41 female, 63 male, 4 no data, median age
66 yrs, range 30-89). 56 patients were christians, 1 patient islamic, further 51
had no membership in a religious group. Cancer type – breast 23, head neck
cancer - 38, prostata - 7, hematological malignances - 6, others – 34. Church
membership or S/R+ self categorization indicate higher levels of needs. Inner
peace, generativity, existentials occur in all patients independetly their religion.
Spiritual experiences (GrAw-7) correlates with all needs. S/R categorization and
spiritual experiences (GrAw-7) correlate with WHO-5 and L-1 scale. ere is
only a weak correlation between GrAw-7 and PIAC, ASKU and lay etiologies.
S/R self categorization and GrAw-7 have correlate with CAM use. Mediations
demonstrate the direct impact of spirituality on CAM use, enhanced by per-
sonal religiosity, experiences (GrAw-7) and discovered needs (SpNQ-20).
Conclusion: We have to discover the hidden needs of our patients to
understand their mental situation. SpC oers and new diagnostic instru-
ments are possible parts of patients empowerment.
Disclosure Statement: e authors declare no conict of interest.
515
The prophylactic hand-foot-cooling Hilotherapy® avoids CIPN
during chemotherapy - is the eect sustainable? Update of
the 4-year Follow UP data
Trudi Schaper; Maren Darsow
Luisenkrankenhaus GmbH, Düsseldorf, Deutschland
Background: Using the hand-foot cooling Hilotherapy® during tax-
ane-based chemotherapy reduced the development of chemotherapy-
induced polyneuropathy (CIPN) ≥ grade 2 signicantly (Schaper et al.
2019). Now the 4-year long-term results are available, to conrm the
Hilotherapy® as a useful and sustainable CIPN prevention.
Methods: In our pilot study 151 breast cancer patients used the degree-
specic cooling system Hilotherm Chemo Care for prophylactic constant
hand-foot cooling (1/2018 – 5/2019). e extremities were cooled during
each chemotherapy (CTX). Cooling was administered 30 minutes before
to 30 minutes aer CTX (device temperature setting 10-12°C). Aer each
CTX-treatment, CIPN symptoms were assessed using CTCAE criteria. To
conrm the sustainability of results, the evaluation of long-term data was
assessed at months 4, 7, 13, 24, 36 and 48.
Result: Out of 151 patients using the prophylactic Hilotherapy®, 141 patients
(93.4%) developed none or mild symptoms of CIPN (grade 0: n=64; grade
1: n = 77). 10 patients (6.6 %) suered from grade 2, 1 patient from grade 3
(0.8%). Symptoms of CIPN were improved partly: 4 weeks aer the last che-
motherapy treatment (EOT) 102 patients (67.5%) showed no toxicities (grade
0), 42 patients (27.8%) had mild symptoms (grade 0-1: n=10 & grade 1: n =
32), 6 patients (4%) suered from grade 2, none showed grade 3 toxicity. 4 – 48
months aer completing CTX 93.0% – 95.8% of all patients are free of ≥ grade
2 CIPN symptoms (grade0-1: months 4 = 94.7%; months 7 = 95.8%; months
13 = 94.0%; months 24 = 93.0%; months 36 = 93.4%; months 48 = 93.7%).
Discussion: CIPN is a severe side eect of many commonly used che-
motherapeutic agents, especially taxane-based regimen (Paclitaxel, nab-
Paclitaxel, Docetaxel) which reduces patients health-related quality of life
for years. Furthermore, it oen entails dose delays, dose reductions or
treatment discontinuations.
Conclusion: e results of this real-world data study propose the prophy-
lactic constant cooling (Hilotherapy®) as a new approach to prevent CIPN
≥ grade 2 signicantly.
Disclosure Statement: e authors declare the following: Advisory borads, Rei-
seerstattungen, Vortragshornore.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 211
526
Adherence and impact of a supervised digital training
program on motor performance and HRQoL: Study protocol
Nicole Soinski1; Gunnar Cario1; Anouk Riou2; Thorsten Schmidt3
1Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Kinder-und
Jugendmedizin, Kiel, Deutschland
2Universitätsklinikum Schleswig-Holstein, Campus Kiel, Zentrum für integrative
Psychiatrie (ZIP), Kiel, Deutschland
3Universitäres Cancer Center Schleswig-Holstein UCCSH, Kiel, Deutschland
Background: Children and adolescents move less than their peers dur-
ing and aer oncological treatment and show reduced fitness and health
related quality of life (HRQoL). e concept of telemedicine is a prom-
ising approach to expand the care structure and to reduce barriers such
as distance, time and costs. e purpose of this study is to investigate
whether a digital training program can be implemented in pediatric
oncology. It investigates adherence, motor performance, and HRQoL.
Results from a previous pilot study showed that a digital exercise program
is feasible and safe in pediatric oncology. It seemed promising in terms of
improving motor performance and HRQoL. is study aims to conrm
these assumptions.
Methods: 20 children and adolescents aged 6 to 18 years with an ini-
tial diagnosis who are undergoing cancer treatment will be included.
e intervention extends over a period of 12 weeks with prescribed 2
training sessions/week. e rst 3 training sessions are carried out
under direct supervision of a sports therapist and then completed by
the participants themselves under weekly telemedical supervision. Each
patients individual plan is accessible from any location via internet.
Adherence is measured by the number of completed prescribed training
sessions/week. Motor performance will be assessed at baseline (T0) and
12 weeks (T2). HRQoL will be measured at baseline (T0), 8 weeks (T1)
and 12 weeks (T2).
Result: Since March 2023, 7 patients were included with an ongoing
recruitment.
Discussion: is study investigates the adherence of a digital exercise
program and its impact on motor performance and HRQoL in children
and adolescents with cancer during treatment. If this study is success-
ful, digital exercise therapy may potentially help to increase HRQoL and
maintain or even improve motor performance in children and adolescents
with cancer. e possibility of digital and location-independent training
could also enable qualied sports therapy regardless of the distance to a
top oncological center.
Disclosure Statement: e authors declare no conict of interest.
547
Kolibri: An explorative long-term study on exercise and
its inuence on physical performance and psychosocial
aspects in childhood cancer patients during and after
cancertreatment
Lena Wypyrsczyk; Mareike Kühn; Elias Dreismickenbecker;
Marie A. Neu; Franziska Ortmüller; Jörg Faber
Universitätsmedizin Mainz, Klinik und Poliklinik für Kinder- und Jugendmedizin,
Schwerpunktbereich Pädiatrische Hämatologie/Onkologie/Hämostaseologie,
Mainz, Deutschland
Background: Medical advances in childhood cancer treatment have sig-
nicantly improved survival rates, increasing the importance of address-
ing long-term eects. Oncological treatment and its side eects are oen
associated with reduced physical activity leading to decits in physical
performance. Recent research indicates that specically tailored exercise
therapy has the potential to reduce treatment-related side eects, enhance
psychosocial outcomes, and optimize physical performance. e study’s
objective is to assess physical and psychosocial functioning of children
and adolescents, in order to expand the knowledge of targeted exercise
therapy in the future.
Methods: A total of 100 children and adolescents between the ages of 3
and 21 with a cancer diagnosis will be enrolled in the trial. Patients will
be recruited during cancer treatment and aercare. Aer inclusion, par-
ticipants will complete physical performance tests (endurance, strength,
mobility, coordination, balance and gait), a questionnaire program
(cancer-related fatigue, quality of life, resilience, mental health, pain)
and an assessment of physical activity and sedentary behavior at multiple
timepoints over a 5-year period.
Result: Patient enrollment started in June 2023. e elaborated compila-
tion of various physical performance tests proved to be feasible and well
accepted. To increase accessibility and response rates, a web-based appli-
cation was developed to allow remote access and use of the questionnaires.
Discussion: e progress already seen in the early stages of the trial is
promising. e data collected provides an insight into the functional sta-
tus of the enrolled patients in terms of physical performance and high-
lights disease- and therapy-related decits.
Conclusion: In the long term, the number of variables collected as well as
the extended time of observation will provide a comprehensive view of the
development of functional status in childhood cancer patients and may
contribute to the evidence base for targeted exercise therapy.
Disclosure Statement: e authors declare no conict of interest.
638
Oncological Exercise Therapy (OTT) with AYA patients in a
clinical context – Results of real-world data
Lena Böhlke; Sophia Printzen; Timo Niels; Freerk T. Baumann
Universitätsklinikum Köln, Centrum für integrierte Onkologie (CIO) Aachen,
Bonn Köln, Düsseldorf, Klinik für Innere Medizin, Köln, Deutschland
Background: AYA patients represent a group for whom it is particularly
important to maintain mental and physical performance during and aer
oncological treatment. Participation parameters, mental health, and phys-
ical tness of AYA patients in an exercise program implemented in a clin-
ical setting will be evaluated.
Methods: An analysis of real-world data of AYA patients who partici-
pated in Oncological Exercise erapy (OTT) at the University Hospital
of Cologne, Germany, between the years 2012 and 2019 was conducted.
Demographic, medical and treatment-associated data of AYA patients
were documented at enrollment. Questionnaires and physical assessments
are used to assess mental health and physical tness during participation
in OTT Program. e sample was analyzed descriptively. e statistical
analysis to determine the eectiveness of the program follows.
Result: A sample of n=227 AYA patients was enrolled over 8 years. First
data show most patients were female (72.7%), with a mean age of 32 years,
diagnosed with breast cancer (39.2%) and during medical treatment
(74%). Additional data on patients’ mental health and physical tness will
be presented at the congress. ese are expected to show a positive eect
of the exercise program.
Discussion: To our knowledge, this is the rst time such real-world data
has been collected and evaluated for AYA patients in an exercise therapy
care model.
Conclusion: While the OTT program has been shown to reach AYA
patients during oncology treatment in a clinical setting, the data suggest
that exercise programs specically tailored to AYA patients are needed to
meet their needs.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts212
672
Get Strong to Fight Childhood Cancer: An Exercise
Intervention for Children and Adolescents Undergoing
Anti-Cancer Treatment (FORTEe)
Elias Dreismickenbecker1; Francesca Lanfranconi2; Marie A. Neu1;
Sandra Stössel1; Lisa Ploch1; Norbert W. Paul3; Christian Ruckes4;
Adriana Balduzzi2; Peter Wright5; Stan Windsor5; Joachim Wiskemann6;
Inaam El Rajab6; Veronika Picmanova7; Barbara Heisserer7;
Rodolf Mongondry8; Wilhelm Bloch9; Katie Rizvi10; Martin Fridh11;
Alejandro Lucia12; Carmen Fiuza-Luces13; Miriam Götte14;
Filippo Spreaco15; Barbara Konda16; Milica Stefanovic17;
Marco Sowa-Israel18; Tobias Baader19; Jörg Faber1
1University Medical Center of the Johannes Gutenberg-University Mainz,
Department of Pediatric Hematology/ Oncology, Center for Pediatric and
Adolescent Medicine, Mainz, Deutschland
2Fondazione Monza e Brianza per Il Bambino e La Sua Mamma, Clinica
Pediatrica, Università degli Studi di Milano Bicocca, Monza, Italien
3University Medical Center of the Johannes Gutenberg-University Mainz,
Institute for the History, Philosophy and Ethics of Medicine, Mainz, Deutschland
4University Medical Center of the Johannes Gutenberg-University Mainz,
Interdisciplinary Centre for clinical Studies (IZKS), Mainz, Deutschland
5Oxford Brookes University, Department of Sport and Health Science and Social
Work, Oxford, United Kingdom
6Heidelberg University Hospital and National Center for Tumor Diseases,
Department of Medical Oncology, Working Group Exercise Oncology,
Heidelberg, Deutschland
7Concentris research management GmbH, Project Management,
Fürstenfeldbruck, Deutschland
8Centre de Lutte Contre le Cancer Léon Bérard, Prevention Cancer Environment
Department, Lyon, Frankreich
9German Sport University Cologne, Department of Molecular and Cellular Sport
Medicine at the Institute of Cardiology and Sports Medicine, Köln, Deutschland
10Youth Cancer Europe, Youth Cancer Europe, Cluj-Napoca, Rumänien
11Department of Pediatrics and Adolescent Medicine, University Hospital
Rigshospitalet, Kopenhagen, Dänemark
12Universidad Europea de Madrid, School of Doctorate Studies and Research,
Madrid, Spanien
13Hospital 12 de Octubre Research Institute, ‚imas12‘, Physical Activity and
Health Laboratory, Physical Activity and Health research group (PaHerg),
Madrid, Spanien
14Essen University Hospital, Exercise Oncology Working Group, West German
Cancer Center, Essen, Deutschland
15Fondazione IRCCS Istituto Nazionale dei Tumori, Pediatric Oncology Unit,
Mailand, Italien
16Forma 3D Ltd, Forma 3D, Ljubljana, Slovenia
17University Medical Center Ljubljana, Division of Pediatrics, Department of
Haematooncology, Ljubljana, Slovenia
18Nurogames GmbH, Nurogames, Köln, Deutschland
19Pixformance Sports GmbH, Pixformance Sports, Dallgow-Döberitz,
Deutschland
Background: Cancer is the leading cause of death by non-communica-
ble diseases in children in Europe. During cancer treatment, patients
morbidity is increased due to e.g. physical inactivity and cancer-related
fatigue. Personalized exercise training during the intensive phase of can-
cer treatment in children and adolescents is a promising therapy to mit-
igate above mentioned issues. However, evidence for using exercise to
counteract fatigue and improve health-related quality of life is lacking in
pediatric oncology.
Methods: e FORTEe research project intends to evaluate a personalized
and standardized exercise intervention in 450 children, adolescents and
young adults undergoing cancer treatment in nine centers across Europe.
is randomized, controlled multicenter trial aims to generate high evi-
dence for an innovative, patient-centered exercise treatment as part of the
standard of care. Experiences and expertise in pediatric exercise oncol-
ogy within Europe were merged to develop specic exercise training and
testing protocols which are to be implemented with the help of digital,
innovative technologies.
Result: e elaborated protocols are standardized to enable adapted per-
sonalized exercise training. A meticulous approach to tailored exercise
includes a sensitive functional evaluation system to set the appropri-
ate exercise dosage, aiming at dening type, frequency and intensity.
Precision exercise training protocols are adapted and personalized to
the cancer patient’s clinical phenotype. e intensity, time and volume of
exercise are adjusted to the cancer treatment intensity and to each patients
clinical condition and response. For this purpose, dierent modalities are
included that allow training sessions in-person but also remotely, sup-
ported by innovative technologies.
Conclusion: As a progress beyond the current state-of-the-art, FORTEe
has the ambition to implement pediatric exercise oncology as an evi-
dence-based standard in clinical care for all childhood cancer patients
worldwide.
Disclosure Statement: e authors declare no conict of interest.
673
Strategies to overcome “uninformed consent” in clinical trials
with cancer patients: A mixed-methods approach to increase
patient understanding and ensure fair access to optimal
cancer care
Christine Bernardi1; Daniel Wol2; Daniel Heudobler2; Florian Lüke2;
Johannes Hies3; Frederike Seitz4; Lisa Boyer1; Tobias Pukrop2;
Wolfgang Herr2; Anne Herrmann-Johns1,5
1Institut für Epidemiologie und Präventivmedizin / Medizinische
Soziologie Regensburg, Regensburg, Deutschland
2Universitätsklinikum Regensburg / Innere Medizin III Hämatologie und
Internistische Onkologie, Regensburg, Deutschland
3Universitätsklinikum Regensburg / Rechtsangelegenheiten, Regensburg,
Deutschland
4Universität Regensburg / Ethikkommission, Regensburg, Deutschland
5University of Newcastle (UoN) / School of Medicine and Public Health,
Newcastle, Australien
Background: In accordance with legal and ethical requirements,
patients should be thoroughly informed about clinical trials in which
they could enroll. is oen leads to lengthy informed consent (IC)
processes during which patients are faced with complex and unfamil-
iar information. is project will develop and pilot test strategies to
improve IC processes.
Methods: Using semi-structured phone interviews, we investigated the
perspectives of cancer patients enrolled in clinical trials, their support
persons (SPs) and IC experts from various elds. Based on these ndings
and using a mixed-methods design, strategies to improve IC processes
were developed and will be tested in a randomized controlled trial.
Result: Most patients and SPs (n=43) felt adequately informed about the
respective trial. However, core aspects of the trial were oen not under-
stood, highlighting a discrepancy between perceived and actual under-
standing. Experts stressed that patients and SPs were oen overwhelmed
by information. Strategies to overcome this can be grouped into three
categories: i) improvement of IC documents, ii) re-structuring the IC con-
versation (e. g. by using a brief conversation protocol), and iii) improved
communication training for all involved stakeholders. ese strategies are
currently being rened with the help of a multidisciplinary expert panel
and will be tested in a subsequent study.
Discussion: Our ndings indicate a lack of cancer patient and SP
understanding of key elements of clinical trials. Due to the discrepancy
between their perceived and actual understanding, clinicians may over-
estimate which information patients actually recall and understand. e
identied strategies could help to improve doctor-patient-communica-
tion in this area.
Conclusion: is is the rst German study to examine the views of cancer
patients, SPs and further experts on IC processes in oncology. Rening
and testing evidence-based communication strategies is likely to facil-
itate fair access to clinical trials and thus foster the provision optimal
patient-centered cancer care.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 213
696
Implementation of the tumor board “Supportive Case
Conference to improve the quality of life of oncological
patients
Eva Schneider1; Iris Bey2; Dirk Waldschmidt3
1University Hospital Cologne, Oncology Nursing Department, Nursing
Directorate, Köln, Deutschland
2University Hospital Cologne, Center for Integrated Oncology (CIO),
Interdisciplinary Tumour outpatient Clinic, Köln, Deutschland
3University Hospital Cologne, Clinic for Gastroenterology and Hepatology, Köln,
Deutschland
Background: In the course of treatment at the Center for Integrated
Oncology (CIO) of the University Hospital of Cologne, highly complex
overall situations of individual oncological patients oen arise that cannot
be satisfactorily resolved with the usual symptom-oriented methods. An
interprofessional consultation aims to enable these patients to cope better
with their disease, the medical therapy and undesired side eects.
Methods: First, a working group of 12 dierent disciplines was formed.
is resulted in the “Supportive Case Conference, consisting of oncol-
ogy specialist nurses, CIO Patient Navigator, physicians, pastoral care,
psychooncology/psychosomatics, pain specialists, social services, onco-
logical exercise therapists, dietetics, natural medicine, traditional Chinese
medicine and palliative medicine specialists. Patients are introduced by a
member of the treatment team, usually a nurse.
Result: Aer a one-year test phase, the “Supportive Case Conference” has
become established and takes place every two weeks as a hybrid meet-
ing. e interdisciplinary recommendations are implemented promptly
(usually within 36 hours) and evaluated at the next meeting. e patients
benet greatly from the detailed discussion of their situation. Also for the
therapeutic team the results lead to a relief.
Discussion: e next steps to be taken are to increase the frequency, to
improve public relations and to integrate scientic outcome assessment.
Conclusion: e “Supportive Case Conference” has proven to be a suc-
cessful instrument for quality improvement in the interdisciplinary care
of heavily burdened oncological patients. e overarching guiding vision
of the CIO nds practical application here: “Together against cancer.
Together for life.
Disclosure Statement: e authors declare the following: wissenschaliches.
701
ESPRIT – Testing the eectiveness of a social prescription
andvirtual patient information to increase tertiary prevention
in cancer patients
Lisa Boyer1; Christine Bernardi1; Sabine Einhell2; Michael Leitzmann3;
Michael Koller4; Tobias Pukrop2; Wolfgang Herr2; Anne Herrmann-Johns1,5
1Institut für Epidemiologie und Präventivmedizin/Medizinische Soziologie
Regensburg, Regensburg, Deutschland
2Universitätsklinikum Regensburg/Innere Medizin III Hämatologie und
Internistische Onkologie, Regensburg, Deutschland
3Institut für Epidemiologie und Präventivmedizin, Regensburg, Deutschland
4Universtitätsklinikum Regensburg/Zentrum für Klinische Studien (ZKS),
Regensburg, Deutschland
5University of Newcastle (UoN)/School of Medicine and Public Health,
Newcastle, Australien
Background: Tertiary prevention through physical activity (PA) and
psychosocial support can improve outcomes of cancer patients, includ-
ing increased survival. However, adoption rates of tertiary prevention
programs remain low. Social prescriptions provide individually tailored
care plans, referring patients to non-clinical services. While they pro-
vide a promising strategy to improve health behavior, further evidence is
required to evaluate their eectiveness. Support persons (SPs) are oen an
important source of information for patients, yet their role in facilitating
patient health behavior remains understudied.
Methods: A single-center randomized controlled trial (RCT) will test the
eectiveness of a social prescription (intervention A) and virtual patient
information (intervention B) in promoting the uptake of PA, social
engagement and psychosocial support among cancer patients and SPs,
in comparison to usual care. Secondary endpoints will encompass over-
all quality of life and self-ecacy of patients and SPs. e study will also
investigate cost-eectiveness, the duration of consultations and further
implementation barriers and enablers. We will examine the endpoints at
baseline, at 3, 6 and 12 months of follow-up.
Result: is is an ongoing study conducted at Comprehensive Cancer
Centre Ostbayern, which serves patients residing mainly in rural areas.
Initial ndings will be presented.
Discussion: is project aims to provide causal evidence regarding the
eectiveness of innovative strategies for enhancing preventive health
behavior and improving outcomes for cancer patients and SPs. A
mixed-methods hybrid design will help to identify eective strategies and
facilitate their integration into routine care.
Conclusion: We will employ evidence-based communication strategies
and a comprehensive, low-cost approach to promote an active lifestyle
among cancer patients and SPs. ese interventions promise a high degree
of adaptability, making them suitable for widespread adoption to address
the needs of various vulnerable patient populations.
Disclosure Statement: e authors declare no conict of interest.
715
Feasibility of exercise as a supportive measure for patients
undergoing checkpoint-inhibitor treatment: A randomized
controlled trail
Jana Müller1; Friederike Rosenberger1; Jessica Cecile Hassel2;
Joachim Wiskemann1
1National Center for Tumor Diseases (NCT) and Heidelberg University Hospital,
Working Group Exercise Oncology, Division of Medical Oncology, Heidelberg,
Deutschland
2National Center for Tumor Diseases (NCT) and Heidelberg University Hospital,
Heidelberg, Deutschland
Background: Immune checkpoint inhibitors, such as the PD-1 antibodies
pembrolizumab and nivolumab, are the standard of care for patients with
metastatic melanoma. ey have signicantly prolonged patient survival,
but also entail some side eects. In addition to the immune-mediated side
eects, fatigue is the most frequent side eect. e SPORTIVUMAB pilot
study investigated safety and feasibility of an exercise intervention pro-
gram (supervised resistance and endurance training) in patients undergo-
ing immune checkpoint inhibitor therapy.
Methods: Forty-eight patients (mean age 60 years; 44% female) were
enrolled. Among other measures, fatigue (MFI) and quality of life
(EORTC QLQ-C30) were assessed at baseline (before the start of immune
checkpoint inhibitor therapy) and aer 12-weeks follow-up. Aer baseline
testing, patients were randomized to the intervention (n=25) or control
group (n=23). Patients randomized to the intervention group trained 2x/
week for a total of 12 weeks during immune checkpoint inhibitor therapy
with a PD-1 antibody.
Result: e dropout rate was 17% (IG n=4, CG n=4), allowing n=40
patients to be included in the intention-to-treat (ITT) analyses. Training
adherence was 62% on average (15 out of 24 prescribed training sessions).
No (S)AEs occurred that were related to the exercise intervention. ITT
revealed no dierences regarding fatigue and quality of life (p>.05).
Discussion: e lack of eects on fatigue and quality of life could be
explained by a lack of adequate training stimulus due to the relatively
low adherence. e eect of the intervention on other patient reported
outcomes, endurance capacity, and management of immunotherapy side
eects need to be investigated in further analyses (results are available for
the DKK Congress 2024).
Conclusion: Based on these preliminary analyses, supervised resistance
and endurance training is feasible in patients undergoing immune check-
point inhibitor therapy.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts214
740
“The most important thing is that you are not left alone”
A Qualitative Study on Challenges, Coping and Needs of
Adolescents and Young Adults with Cancer Focusing on the
Life-Threat
Carolin Wilharm1; Saskia Blütgen1; Mara Weiß1; Anne Pralong1;
Michael Hallek2; Raymond Voltz1; Armin Tuchscherer2; Steen T Simon1
1Zentrum für Palliativmedizin Uniklinik Köln, Köln, Deutschland
2Klinik 1 für Innere Medizin Uniklinik Köln, Köln, Deutschland
Background: Cancer aects adolescents and young adults (AYA) at a life
period marked by transitions, where death seems far away. erefore, the
aim of this study was to explore the challenges, coping strategies, and
needs of AYAs with cancer focusing on the life-threat.
Methods: Patients aged between 18 and 39 years at diagnosis of any malig-
nancies were interviewed 2-5 years aer diagnosis when treatments had
been completed. Interviews were analyzed using qualitative content analysis.
Result: Fieen AYAs (mean 27,33y. at diagnosis, 9 female) were inter-
viewed. e sudden confrontation with existential concerns through a dis-
ease and its therapy, about which the AYAs knew little previously, led to
an emotional overload. AYAs experienced helplessness, fears and insecu-
rities that could restrict them in their entire life persistently. Nevertheless,
hope was described as prevalent throughout therapy. Simultaneously, most
avoided thoughts of a possible death. Others, however, found it soothing to
view death as acceptable or saw it as a chance to rethink their lives. Contact
with patients and survivors of the same age was described as helpful, but
witnessing their death posed a strong burden. Relatives were seen as the
main source of support, but AYAs also worried about them. Participants
had a high need for guidance and supporting services. Aer the end of ther-
apy, AYAs were challenged by the enduring changes in their lives that could
aect their careers and distanced them from healthy peers.
Discussion: Although there are similarities to older cancer patients, sig-
nicant dierences, such as inexperience and unexpectedness of a can-
cer diagnosis or the responsibility for own children, must be recognized.
ere are initial support services for AYAs unique needs, but these are far
from being suciently available.
Conclusion: Further research on AYAs’ needs regarding life-threat in a
curable state is needed. Expanding existing services and increasing inter-
action among health care professionals and patients, particularly in their
guidance, can improve the quality of care for AYAs.
Disclosure Statement: e authors declare no conict of interest.
773
Nutritional status of cancer patients in the rst year
afterdiagnosis
Judith Büntzel1; Milan Djordjevic2; Christoph Bauer-Büntzel3; Jens Büntzel2
1UMG Universitätsmedizin Göttingen, Göttingen, Deutschland
2Südharz Klinikum Nordhausen, Nordhausen, Deutschland
3Klinikum Fulda, Fulda, Deutschland
Background: Nutritional status is accepted as an independent prognostic
factor in the follow-up of cancer patients (pts). But - what is the normal
weight course on patient‘s way to cancer survivorship?
Methods: In a retrospective way we analyzed data of high-grade B-cell
lymphoma patients (HGBCL = systemic disease) and head neck cancer
patients (HNC = locoregional disease). Body weight, BMI, serum albumin
and C-reactive protein were (CrP) registered at time points T0 (diagno-
sis), T1 (+3 month), T2 (+6 month), T3 (+9 month), and T4 (+12 month).
To compare both groups we used an independent t-test, to compare the
course within a group, we used dependent instrument.
Result: We included 97 BCL and 49 HNC (101 male, 47 female). e
mean age was 63.08 +/-12.76 years. ere were no dierences between
both groups in age, BMI, and gender ratio. e course of nutritional status
diers signicantly (p<0.001): At time points T1/T2/T3/T4, HGBCL pts
have shown weight loss in 30.14/36.67/37.21/35.29% compared to HNC
pts in 35.56/56.52/54.55/47.73%. Weight gain was seen for HGBCL group
in 5.48/13.33/16.28/26.47% compared to 0/0/4.55/4.55% in HNC group.
Decreased albumin and increased CrP are typical for HGBCL pts at all
time points. HNC pts show only increased CrP at T1 and T2.
Discussion: Successfully treated high grade B cell lymphoma patients
(systemic diseases) will stabilize their nutritional status in the rst year
aer diagnosis. In contrast, head neck cancer patients (locoregional
diseases) will really start their nutritional challenge aer nishing their
cancer therapy.
Conclusion: Nutritional monitoring and support programs have the most
impact on cancer survivorship aer locoregional diseases and problems
(HNC, GI cancer).
Disclosure Statement: e authors declare no conict of interest.
781
Assessing nutrition status and tness in patients of an
interdisciplinary hemato-oncological university outpatient
clinic - feasibility and rst experiences
Manina Albrecht1; Sandra Windschüttl1; Florian Lüke1,2; Luzia Valentini3;
Tobias Pukrop1; Michael Koller1; Sabine Einhell1
1Universitätsklinikum Regensburg, Regensburg, Deutschland
2Fraunhofer-Institut für Toxikologie und Experimentelle Medizin ITEM,
Regensburg, Deutschland
3Hochschule Neubrandenburg, Neubrandenburg, Deutschland
Background: Hemato-oncological patients are treated according to cur-
rent guidelines. However, especially in borderline cases, objective and
universal parameters for decision making are oen missing in the daily
routine. e standardized assessment of nutritional and physical status
could support this process. erefore, the aim of this study was to evaluate
the time needed for a malnutrition and sarcopenia screening and to assess
their feasibility.
Methods: e prospective monocentric cohort study was conducted
over 3 consecutive visits (3-4 week intervals). Adult hemato-oncological
patients at the start of their actual therapy were included. Malnutrition
screening and diagnosis were performed using Patient-Generated
Subjective Global Assessment (PG-SGA) and Global Leadership Initiative
on Malnutrition (GLIM) criteria. Sarcopenia screening was performed
using Strength, Assistance with walking, Rise from a chair, Climb stairs
and Falls (SARF-F). Examination times were documented at each visit.
Result: Twenty-nine patients were included (69% men, 60 ± 14 years,
body mass index 26.1 ± 4.6 kg/m²). Screening time decreased from 33.4 ±
7.3 min at visit 1 to nally 20.5 ± 5.5 min at visit 3. Overall, 55.2 % (n=16)
of patients were at risk of malnutrition (n=14 moderate, n=2 sever)
according to PG-SGA. Malnutrition was diagnosed in 27.5 % of patients
(n=1 moderate, n=7 severe) using GLIM. A risk for sarcopenia (SARC-F
≥ 4 points) was detected in 20.7% (n=6) of patients.
Discussion: Even aer 3 visits, the assessments were still associated with
a signicant time requirement and could only be fully covered by an addi-
tional full-time dietitian. e percentage of patients with malnutrition
and risk of sarcopenia was within the range reported in the literature.
Conclusion: rough a reduction to key parameters, a feasible test set
has been identied. is will now be analyzed in a further study (BASiQ
Compass Trail) with a larger number of patients.
Disclosure Statement: e authors declare no conict of interest.
790
Decits in phytotherapeutic education amongst medical
stain cancer care
Gina Westhofen; Judith Büntzel
Klinik für Hämatologie und Medizinische Onkologie, Universitätsmedizin
Göttingen, Göttingen, Deutschland
Background: Cancer patients are known to use phytotherapy (PT), how-
ever, there is an information gap between the status quo of PT usage and
the actual knowledge of the medical sta (MS) about patients’ application:
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 215
e majority of patients does not inform their attending physicians about
PT usage, neither do these inquire about the topic in anamnesis. e aim
of our study was to evaluate 1) if MS assesses usage of PT and 2) the state
of knowledge on symptom focused PT.
Methods: An open questionnaire was completed by 108 participants (PA)
(64 medical students, 43 MS, 2 PA gave no information), allowing for
every PA to assess their own expertise, lack thereof and structural dicul-
ties in information transfer regarding PT. Using a numeric rating system
(1 - 6), a self-assessment for therapeutic options of dierent symptoms
was analyzed. Furthermore, the priority of PT anamnesis was evaluated.
Result: e survey was completed by 108 PA. PT anamnesis was rated as
important by 77% of the PAs, whereas only 41% stated to assess PT anam-
nesis on a regular basis (p = 0.1112). In self-assessment, all PAs claimed
a lack of consultation capacity, rating their own knowledge at a median
of 4 (physicians) and 5 (medical students and nurses), corresponding to
a failing grade. e overall rating, but also in every symptom category,
physicians assessed their consultation capacity better than students (p <
0.0001), in addition, physicians with pre-existing education in comple-
mentary and alternative medicine/PT rated their skills better than non
pre-educated colleagues (p = 0.0008). e majority of PAs stated PT coun-
selling falls within the responsibilities of physicians.
Discussion: Our survey conrms the known decits in PT competence
of MS. Furthermore, it suggests an unattended need for PT education and
knowledge transfer on PT usage amongst cancer patients.
Conclusion: ere is an unattended demand for PT education amongst
MS and medical students.
Disclosure Statement: e authors declare no conict of interest.
828
ONCOSCREEN – Evaluation of a psychosocial and supportive
care screening in cancer patients
Ilka Ratjen1; Friederike Stölzel2; Matteo Agius3; Romina Clemens3;
Lydia Cordesmeyer4; Felix Dittmann3; Lisa Gesewsky5; Evgeni Knispel3;
Marie von Lehmden3; Julia Medlin4; Livia Schmid3; Malte Fynn Söhl4;
Anna Franziska Hamm6; Christina Schwitlick7; Cyrus Khandanpour7;
Anne Letsch2
1University Hospital Schleswig-Holstein (UKSH), Kiel, Deutschland
2University Cancer Center Schleswig-Holstein, Kiel, Deutschland
3Christian Albrechts University, Kiel, Deutschland
4University of Lübeck, Lübeck, Deutschland
5C, Kiel, Deutschland
6University Hospital Schleswig-Holstein (UKSH), Lübeck, Deutschland
7University Cancer Center Schleswig-Holstein, Lübeck, Deutschland
Background: Many cancer patients do not report their supportive care
needs of their own volition. To identify cancer patients’ demand for
psychosocial and/or further supportive care, screening instruments are
routinely applied in certied cancer centers. ONCOSCREEN evaluates a
widened supportive cancer care screening (SCCS).
Methods: Starting in June 2023, participating in- and outpatient cancer
patients treated at the University Hospital Schleswig-Holstein are asked to
ll in SCS questionnaires, consisting of the NCCN Distress ermometer
and Problem List, the Minimal Documentation System, a nutrition
self-report questionnaire leaned on the Nutritional Risk Score and the
Minimal Nutritional Assessment, questions on physical activity from the
Bewegungs- und Sportaktivität questionnaire (BSA) and overall scores on
quality of life based on the EORTC QLQ-C30. As recruitment is ongoing,
preliminary data on study sample characteristics and psychosocial distress
are presented.
Result: Up to August 15th 2023, more than 326 patients participated
in ONCOSCREEN, comprising 145 patients with hematological,
41 urological, 41 nasopharynx/oropharynx/mouth, 39 gynecological, 38
gastrointestinal, 13 musculoskeletal, 8 lung and 1 neuroendocrine can-
cers. Mean age was 63±13.5 years (range, 19-89 y), 45% of the participants
were female. Mean value on the distress thermometer was 4,9±2,6, with
185 patients (57%) having a score of ≥ 5 which is dened as indication for
psychosocial care need.
Discussion: e ONCOSCREEN cohort consists of a broad range of
oncological patients representing the whole adult age range. Preliminary
results on psychosocial distress in ONCOSCREEN are in line with nd-
ings of other studies. A substantial proportion of patients show high dis-
tress scores exemplifying the need for psychosocial supportive care.
Conclusion: First results of the ongoing ONCOSCREEN-study show a
high need of psychosocial supportive care measures and reinforce the goal
of evaluating a comprehensive SCCS.
Disclosure Statement: e authors declare no conict of interest.
847
Three-year Experience of the Interdisciplinary CIO iTox-Board
for Management of Immune-Related Adverse Events with
Immune-Checkpoint Inhibition
Paul J. Bröckelmann1; Rieke N. Fischer1; Dirk Waldschmidt2; Michael
Faust3; Norbert Galldiks4; Katharina Seuthe5; Philipp Kasper2; Philipp Koll6;
Selina Hahn7; Alexander Quaas8; Thorsten Persigehl9; Michael Hallek1;
Cornelia Mauch6; Nicole Kreuzberg6
1University Hospital of Cologne, Department I of Internal Medicine, Center
for Integrated Oncology Aachen, Bonn, Cologne & Dusseldorf (CIO ABCD),
Cologne, Deutschland
2University Hospital of Cologne, Departmentof Gastroenterology and
Hepatology, Center for Integrated Oncology Aachen, Bonn, Cologne &
Dusseldorf (CIO ABCD), Cologne, Deutschland
3University Hospital of Cologne, Department of IV of Internal Medicine,
Cologne, Deutschland
4University Hospital of Cologne, Department of Neurology, Cologne,
Deutschland
5University Hospital of Cologne, Department of Cardiology, Cologne,
Deutschland
6University Hospital of Cologne, Department of Dermatology, Center for
Integrated Oncology Aachen, Bonn, Cologne & Dusseldorf (CIO ABCD), Cologne,
Deutschland
7CIO Cologne, University Hospital of Cologne, Center for Integrated Oncology
Aachen, Bonn, Cologne & Dusseldorf (CIO ABCD), Cologne, Deutschland
8University Hospital of Cologne, Department of Pathology, Cologne,
Deutschland
9University Hospital of Cologne, Department of Radiology, Cologne,
Deutschland
Background: Immune-checkpoint inhibitors (ICI) rapidly became main-
stay of contemporary cancer treatment and are increasingly utilized in
curative intent. Management of immune-related adverse events (irAE),
which may be life-threatening, is oen challenging. To improve manage-
ment of severe and/or steroid-refractory irAEs we established the inter-
disciplinary iTox-Board at CIO Cologne in 09/2020 and expanded it to the
CIO ABCD and aliated external caregivers in 10/2021.
Methods: Retrospective analysis of all referrals to our bi-monthly CIO
iTox-Board (09/20-08/23).
Results: A total of 121 suspected irAEs (median/month=3.4) aecting
102 patients with a median age of 64 years (range 25-86, IQR 57-70) were
discussed (CIO Cologne 82%, CIO ABCD external 11%). Lung (29%),
skin (19%), urologic (15%) and head & neck (14%) cancers were most
common. Most patients had stage 4 disease (87%), a response to ICI
(CR 10%, PR 37%, SD 30%, PD 23%) and impaired ECOG (median=1,
range 0-3, IQR 0-1) at iTox-Board consultation. Most patients received
pembrolizumab (52%) and ICI in combination with other agents (54%,
aPD1+aCTLA 22%, ICI+TKI 14%). Median time between start of ICI
and rst iTox-Board consultation was 2 months (range 0-94, IQR 1-7).
Suspected irAEs were mostly conrmed by the iTox-Board (86%), rarely
histologically veried (20%) and had a median severity of °3 (range 1-4,
IQR 2-3). Common leading irAEs were pneumonitis (15%), hepatitis
(14%), endocrine (13%), neurologic (10%), (cardio)myositis (8%) and
enteritis (8%). Multiple irAEs co-occurred in 18% of instances and ICI
discontinuation was recommended in 38% of cases.
Discussion: e CIO iTox-Board receives an increasing number of refer-
rals, including from external caregivers, and mostly provides guidance for
high-grade early onset potentially life-threatening irAEs.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts216
Conclusion: As a well-established regularly occurring interdisciplinary
conference, the CIO iTox-Board contributes to improved care of the rap-
idly growing number of patients receiving ICI-based treatments across
health-care sectors.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
866
„Aktiv leben mit Krebs“: acceptance and eect of a low-
threshold information on health behavior for cancer patients
Nadja Knauthe1; Vera Fieber1; Melanie Glausch1; Mark Enrik Geissler2;
Anna Dallal3; Konrad Doll3; Lisa Meister3; Marie Tallarek4;
Sandra Weigmann-Faßbender1; Nadine Giesemann1; Christine Hofbauer1;
Martin Bornhäuser1,5; Anne Letsch6; Ilka Ratjen7; Jacob Spallek4;
Friederike Stölzel6
1National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Deutschland
2Technical University of Dresden (TUD), Dresden, Deutschland
3Christian Albrechts University Kiel, Kiel, Deutschland
4Brandenburg University of Technology (BTU), Cottbus, Deutschland
5Universitätsklinikum Carl Gustav Carus Dresden, Medizinische Klinik und
Poliklinik I, Dresden, Deutschland
6University Cancer Center Schleswig-Holstein (UCCSH), Kiel, Deutschland
7University Hospital Schleswig-Holstein (UKSH), Kiel, Deutschland
Background: In Germany, more than 4.65 million people are currently liv-
ing with a cancer diagnosis. Patients can benet from a healthy lifestyle both
during and aer therapy. In order to provide patients with practical and
scientically based information on health behavior, the authors developed
Aktiv leben mit Krebs” (ALMIK) using participatory program planning.
Methods: A non-blinded randomized controlled trial with intervention
(IG) and wait list control group (WCG) was conducted at NCT/UCC
Dresden and UCCSH in Kiel in 2022/2023 with a convenience sample of
n=227 patients during and aer therapy (65.7 years ± 11.7, 54.2% male).
IG and WCG received a questionnaire at baseline and aer 1 month.
IG received the ALMIK brochure and a link to the website with videos.
Changes in health literacy (HLS-EU Q) and acceptance were assessed.
Result: Acceptance of ALMIK in IG was high: 94.1% of all n=109 patients
in the IG reported having used the brochure. 40.4% had visited the web-
site. Videos were used by 36.7%. Almost all patients rated the brochure as
understandable (97.8%), relevant (90.3%) and clearly presented (98.9%).
Patients also rated the website as well-structured (95.6%) and attractively
designed (97.6%), and the videos as understandable (93.0%) and relevant
(79.1%). Overall, 97.8% were satised with the program and 98.9% would
recommend it to others. Patients of IG did not achieve higher HLS-score
in comparison to WCG (p=0.75).
Discussion: e brochure was used by many patients and was very well
accepted. e website and videos were used less frequently, but overall
by more than one-third of patients, who were also satised with them.
Health literacy was not increased by ALMIK, which may be due to the low
intervention strength.
Conclusion: e high number of participants who used ALMIK indicates
a high need for health behavior information for cancer patients. Patient
involvement has proven to be an important component in creating well
accepted program materials.
Disclosure Statement: e authors declare no conict of interest.
916
Eects of acute exercise on circulating immune cells in
adolescents and young adults undergoing cancer treatment
Isabella Deppe1,2; Ronja Beller1,2; Fabian Kiehl2,3; Nico de Lazzari2,4;
Sabrina B Bennstein5; Dirk Reinhardt1,2; Uta Dirksen1,2; Miriam Götte2,4
1Pediatric III, West German Cancer Center, University Hospital Essen, University
Duisburg-Essen, Essen, Deutschland
2German Cancer Consortium (DKTK), site Essen, National Center for
Tumordiseases site Essen, University Hospital Essen, Essen, Deutschland
3Department of Palliative Medicine, West German Cancer Center Essen,
University Hospital Essen, Essen, Deutschland
4West German Cancer Center Essen, University Hospital Essen, Essen,
Deutschland
5Institute for Transplantation Diagnostics and Cell Therapeutics, Medical Faculty,
Heinrich-Heine University Düsseldorf, Düsseldorf, Deutschland
Background: ere is evidence, that acute exercise mobilizes immune
cells, particularly natural killer (NK) cells into the circulation of patients
with breast cancer, prostate cancer and lymphomas. Mobilized immune
cells appear to play an important role in the anti-tumor eect. e aim of
this study was to investigate the response of immune cells to high inten-
sity interval training (HIIT) in adolescents and young adults (AYAs) diag-
nosed with cancer.
Methods: 20 AYA cancer patients (25 ± 7 years old) and 20 matched
healthy controls (27 ± 5 years old) completed a 20 minutes of HIIT on a
bicycle ergometer. Heart rate, oxygen saturation, perceived exertion rate,
watt power and adverse events were monitored during exercise. Blood
samples were taken before (T0), aer (T1) the exercise intervention and
aer a one-hour recovery period (T2). NK cells, innate lymphoid cells
(ILCs) and their subgroups were determined by ow cytometry.
Result: e total number of NK cells and ILC’s respectively, their sub-
groups CD56dim NK cells, ILC1-like and ILC2 increased signicantly in
both groups from T0 to T1 and decreased aer the one-hour recovery
period (T2). CD56bright NK cells and ILCP (ILC precursor) changed sig-
nicantly from T0 to T1 and T1 to T2 in the control group but not in the
patient group. e percentage changes in immune cells from T0 to T1 or
T1 to T2 did not dier signicantly between the two groups.
Discussion: e increase in mobilized immune cells could be explained
by their response to epinephrine and ß-adrenergic receptors, whereas an
explanation for decrease in NK cells from T1 to T2 might be the migration
of cells to organs during the recovery phase.
Conclusion: A single bout of HIIT results in increased peripheral blood
mobilization of NK cells and ILCs in AYA cancer patients comparable
to healthy controls. Exercise may therefore play an important role in the
defence against pathogens or neoplastic cells.
Disclosure Statement: e authors declare no conict of interest.
923
Four month of exercise intervention improves balance,
eye-hand-coordination and cardiovascular functioning in a
choroidal melanoma patient: a case report
Michael Mendes Wefelnberg; Ludwig M. Heindl; Alexander Rokohl;
Freerk T. Baumann
Uniklinik Köln, Köln, Deutschland
Authors’ aliations: 1Department 1 of Internal Medicine, Center
for Integrated Oncology Aachen, Bonn, Köln, Düsseldorf, University
Hospital of Köln, Köln, DE
Introduction: Choroidal melanoma is the most common eye cancer with
high overall mortality. Patients frequently suer from severe visual and
functional impairments. Eective supportive therapies are widely lacking.
We studied the ecacy of a four-month clinical exercise program parallel
to radiation and immune therapy on cardio-respiratory tness (CRF) as
well as visual and functional tests (VFT).
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 217
Methods: is prospective intervention case study focuses on a 61-year-
old female patient diagnosed with metastatic choroidal melanoma in
the right eye who was set to undergo Cyberknife radiation and immune
therapy for treatment. Data were collected on ve occasions: baseline
(to), post-Cyberknife (t1), pre- (t2), intermediate (t3) and post-immune
therapy (t4). e response in VFT and CFR to exercise intervention were
examined. We conducted two sessions per week of high-intensity interval
training (HIIT) and visual-coordinative exercises.
Results: Signicant improvements were observed for VFT between t0 and
t4 overcompensating radiotherapy-induced declines in t1. CRF initially
improved and then stabilized under immune therapy. Specically, indi-
vidual progressions in balance and eye-hand coordination (EHC) demon-
strated increments of 133% and 8% respectively. VO2 uptake and peak
power output increased by ~7 mL·kg·min-1 and 30 W respectively up until
t3 and declined by ~3 mL·kg·min-1 and 15 W respectively in t4.
Conclusion: e current case report’s data demonstrated improvements
in balance as well as EHC and stabilized CRF levels under immune ther-
apy. Further research is required to extend these ndings to a larger
choroidal melanoma patient cohort.
Disclosure Statement: e authors declare no conict of interest.
932
Eight weeks of exercise intervention improves visual and
cardiovascular functioning in a choroidal melanoma patient:
a case report
Michael Mendes Wefelnberg; Madeline Moll; Ludwig M. Heindl;
Alexander Rokohl; Damir Zubac; Freerk T. Baumann
Uniklinik Köln, Köln, Deutschland
Authors’ aliations
1Department 1 of Internal Medicine, Center for Integrated Oncology
Aachen, Bonn, Köln, Düsseldorf, University Hospital of Köln, Köln, DE
Introduction: Choroidal melanoma, the most prevalent eye cancer glob-
ally, is highly mortal and frequently leads to sweeping visual and func-
tional impairments. We studied the eects of an 8-week exercise program
on visual and functional tests (VFT), cardiorespiratory tness (CRF) and
microvascular circulation in a moderately active young male.
Methods: is prospective intervention case study focuses on a 29-year-
old male patient diagnosed with choroidal melanoma who was set to
undergo radiation brachytherapy for treatment. Data were collected on
three occasions: baseline, transitional, and nal assessments. VFT, CFR,
and the response of microvascular circulation (evaluated via icker
light-induced dilation, FID) to exercise were examined. e exercise reg-
imen entailed high-intensity interval training (HIIT), coupled with visu-
al-coordinative exercises.
Results: Following an 8-week exercise intervention, signicant improve-
ments were observed in CRF, VFT, and microvascular circulation.
Specically, individual progressions in visu-motor reaction time (VMRT)
and eye-hand coordination (EHC) showed increments of 35.9% and
11.1% respectively. Moreover, V
O2 uptake increased by ~7 mL·kg·min-1,
and peak power output surged by 50 W. Ultimately, the dilation of both
arteries and veins in response to FID stimulus exhibited a twofold increase
compared to baseline levels.
Conclusion: In a focused 8-week program, exercises improved EHC,
VMRT and CRF levels. Interestingly, vascular endothelial function also
improved post-exercise. Further research is required to extend these nd-
ings to a larger choroidal melanoma patient cohort.
Disclosure Statement: e authors declare no conict of interest.
955
Variability in resistance training trajectories of breast cancer
patients undergoing therapy
Maximilian Köppel1; Karen Steindorf2; Martina Schmidt2;
Joachim Wiskemann1
1Nationales Centrum für Tumorerkrankungen – NCT, Heidelberg, Deutschland
2Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
Background: Progression in training volume in resistance training (RT)
during the training sessions (TS) over the course of an exercise interven-
tion, is an important indicator of training ecacy. However, as research
has shown, these growth-trajectories can dier substantially between
individuals. A proper understanding of these patterns is crucial for exer-
cise planning, especially in clinical populations. We investigated the varia-
tion of the measured gain in training volume between exercises as well as
between individual patients.
Methods: In total 69 breast cancer patients undergoing adjuvant cancer
treatment from two randomized controlled trails were investigated. ey
conducted 12-weeks of progressive RT. We tted a quadratic Bayesian
regression model to the baseline standardized training volume over the
course of the intervention. We allowed all parameters to vary between
exercises and individuals.
Results: We estimated a positive linear component of 0.093 (95%
Uncertainty interval (UI) 0.058 to 0.120) and a negative quadratic com-
ponent of -0.002 (95% UI -0.008 to 0.001) for the overall change in train-
ing volume per TS. For the dierent exercises we observed a standard
deviation for both the linear (0.043, 95% UI 0.018 to 0.082) and the qua-
dratic component (0.002, 95% UI <0.001 to 0.004). e between-indi-
vidual distribution of the parameters appears to be substantially larger.
Extrapolation of the regression model indicates the trajectory meets a
plateau aer a median of 20.6 TS (95% UI 14.8 to 44.4).
Discussion: We observed large inter-individual variation regarding the
resistance training progression in breast cancer patients undergoing
tumor therapy and a smaller but still relevant variation between dier-
ent exercises. We further observed that the training response will even-
tually plateau.
Conclusion: Exercise therapy in cancer patients might benet from
a more personalized approach regarding training composition. e
non-linear character of the trajectory demands the application of period-
ization schemes.
Disclosure Statement: e authors declare no conict of interest.
Surgical Oncology including Robotics
824
Innovations in Musculoskeletal Surgery -Fluorescence
Imaging Guidance and Photodynamic Therapy in
Orthopaedic-Onocolgy
Frank Traub
Universitätsmedizin Mainz, Mainz, Deutschland
Background: In oncological surgery, primarily CT and MRI is used pre-
operatively to determine tumor boundaries and to plan the resection.
ese imaging methods can only be used in real-time in the operating
theatre to a very limited extent and have limited tumor specicity.
Photodynamic therapy (PDT) and uorescence imaging are two inno-
vative techniques that have signicantly impacted the eld of oncol-
ogy surgery. ey oer valuable tools for both diagnosis and treatment,
enhancing the precision and eectiveness of surgical procedures.
Methods: Fluorescence imaging and Photodynamic therapy are a mini-
mally invasive techniques using dyes light to selectively target and destroy
cancerous cells.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts218
e possibilities and the results of PDT and Fl are to be shown on the basis
of our own laboratory tests and examples from clinical use.
Result: Apoptosis could be induced especially in bone metastases of
breast carcinomas. In bone metastases of renal carcinomas, senescence
was induced but not apoptosis. In so tissue sarcomas, the results were
very diverse. us, induction of apoptosis was seen in leiomyosarcomas
and desmoid tumours.
FI guided resection showed very good results. In particular, in angio-
sarcomas. Also in some other STS tumor extensions could be identied
intraoperatively and thus a histological R0 resection could be performed.
Discussion: So tissue sarcomas and Bone metastasis have dierent sensi-
tivity to the exposure of 5-ALA PDT, resulting in cell fate apoptosis or senes-
cence, depending on the extent of the cellular damage. We found that PDT
has potential applicability in bone metastases of invasive ductal carcinoma
and in Leiomyosarcoma and Desmoid tumors. Intraoperative FI resection
has shown to be a valuable tool in order to reach negative resection margins.
Conclusion: ese techniques contribute to more precise and eective
surgeries, leading to better patient outcomes and potentially reducing the
need for follow-up interventions.
Disclosure Statement: e authors declare no conict of interest.
Thoracic Cancer
574
Tumor Treating Fields (TTFields) In GEneral Routine clinical
care in patients with pleural mesothelioma (TIGER Meso)
Martin Metzenmacher1; Christian Grohé2; Till Plönes3; Federica Grosso4;
Giovanni Ceresoli5
1Universitätsklinikum Essen, Essen, Deutschland
2Johannesstift Diakonie, Berlin, Deutschland
3Fachkrankenhaus Coswig, Coswig, Deutschland
4Ospedale Alessandria, Alessandria, Italien
5Humanitas Gavazzeni, Bergamo, Italien
Background: Pleural mesothelioma (PM) is a rare cancer that is com-
monly associated with asbestos exposure. Due to its diuse and distinct
dispersion in the pleura, an R0 resection is hard and the prognosis bad.
Recently, checkpoint inhibitors showed an extension of overall survival
(OS) in unresectable PM, but a high unmet medical need for eective
treatment remains. Tumor Treating Fields (TTFields) are low-intensity,
intermediate frequency alternating electric elds that inhibit cancer
cell division. In a phase 2 study (STELLAR), adding TTFields to peme-
trexed plus cisplatin or carboplatin yielded encouraging results regarding
median OS and progression-free survival. ere is interest among pre-
scribing physicians to validate these results in routine clinical care. e
aim of this study is to evaluate safety and ecacy of TTFields in routine
clinical care of PM, as well as changes in quality of life (QoL), treatment
duration and device usage.
Methods: e TIGER Meso study is a non-interventional, observational,
prospective study to be conducted in Germany, Italy and the Netherlands
(NCT05538806). Patients with PM without an option of curative resection
who are eligible for TTFields therapy will be asked for consent for study
participation. TTFields will be delivered non-invasively and locoregion-
ally at a frequency of 150kHz by placing transducer arrays connected to
a portable medical device on the thorax. At baseline and months 3 and 6
aer treatment start, demographic data and QoL (EQ-5D-5L, QLQ-LC13,
and LCSS-Meso questionnaires) will be assessed. For the remaining end-
points, follow-up visits will be scheduled every 2-4 months in line with
routine clinical care recommendations. e planned number of patients is
about 200 with a follow-up period of 18 months.
Results: e TIGER Meso study is currently enrolling patients.
Conclusion: e TIGER Meso study will generate prospective data for
the use of TTFields in routine clinical care of PM. e study supports
the evaluation of treatment-related data, which could play a role in future
assessment of treatment duration and usage.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
756
PET-CT detects response to treatment with ipilimumab and
nivolumab in malignant mesothelioma better than CT
Daniel Christoph1; Martin Metzenmacher2; Servet Bölükbas2;
Jan Volmerig1; Georg Nilius1; Prof. Dr. Detlef Moka3; Hubertus Hautzel2
1Evang. Kliniken Essen-Mitte, Essen, Deutschland
2Universitätsklinikum Essen, Essen, Deutschland
3Zentrum für Nuklearmedizin Essen, Essen, Deutschland
Background: Ipilimumab and nivolumab are used as rst-line treat-
ment or patients (pts) with unresectable malignant mesothelioma (MM).
Response assessment by CT using modied RECIST might miss detection
of response. PET-CT based assessment might recognize more pts benet-
ting from this therapy.
Methods: A retrospective analysis of pts with unresectable MM receiving
rst-line ipilimumab and nivolumab was performed. Pts got a baseline
PET-CT scan to clarify resectability before the start of systemic therapy.
Scans were repeated aer every 12 weeks of treatment. ORR was calcu-
lated by using RECIST v1.1, mRECIST, PERCISTSULpeak and PERCISTMTV
were used separately to categorize responders.
Results: 30 pts (22 male (73.3%) and 8 female (26.7%) received a baseline
PET-CT and underwent therapy with ipilimumab (1 mg/kg, d1, q6w) and
nivolumab (360 mg abs., d1+22, q6w). Regarding histology, 18 pts (60%) suf-
fered from epithelioid, 4 pts (13.3%) from sarcomatoid and 8 pts (26.7%)
from biphasic mesothelioma. Origin of the mesothelioma were pleura in
25 pts (83.3%) and peritoneum in 5 pts (16.7%). Due to clinical progres-
sion and/or adverse events, a follow-up PET-CT was performed only in
21 pts (70%), while 3 pts have recently started therapy. In 2 pts CT scan
showed progressive disease. Both pts continued treatment due to metabolic
response detected in PET-CT scans. Another patient showed progression
aer 2 cycles, continued therapy due to clinical benet and responded well
aer 4 cycles (pseudo-progression). According to follow-up PET-CT scans,
10 pts responded (45.5%), 8 pts achieved disease stabilization (36.4%) and
4 pts showed progression (18.1%). Median PFS was 8.5 months, median OS
was 21.2 months. Detailed response assessment with RECIST v1.1, mRE-
CIST, PERCISTSULpeak and PERCISTMTV will be reported at the meeting.
Discussion: During therapy with ipilimumab and nivolumab, more pts
showed metabolic compared to morphological responses.
Conclusion: PET-CT scans based response assessment identies MM pts
responding to ipilimumab and nivolumab better than CT scans.
Disclosure Statement: e authors declare the following: COIs werden in der
Präsentation bzw.im Poster aufgelistet.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 219
Translational Oncology
22
A best practice model for optimizing medication safety
withoral antitumor therapy: Implementation of the AMBORA
care program in real-world clinical routine
Lisa Cuba1,2,3; Katja Schlichtig2,3; Pauline Dürr1,2,3; Martin F. Fromm2,3;
Frank Dörje1,3
1Pharmacy Department, Erlangen University Hospital, Erlangen, Deutschland
2Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-
Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Deutschland
3Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital,
Erlangen, Deutschland
Background: e randomized AMBORA trial1 (Medication Safety with
Oral Antitumor erapy) reported considerable benets of a clinical phar-
macological/pharmaceutical care program for patients treated with oral
antitumor therapeutics (e.g., reduction of severe side eects). However,
generating evidence for the ecacy of an intervention is not sucient to
bridge the gap between research and practice.
Methods: e AMBORA Center investigates the translation of this evi-
dence-based program (including e.g., patient consultations, a counseling
service, and training events) into routine care. We follow the RE-AIM
framework to analyze implementation outcomes while assessing its clin-
ical eectiveness in real-world. Qualitative data gathered by semi-struc-
tured stakeholder interviews and surveys among patients and physicians
is used to evaluate the implementation process. ereby, we aim to derive
a best practice model.
Result: Within two years, 304 councils were conducted and 420 patients
were referred to the AMBORA Center by 15 clinical units within 7 dif-
ferent institutions. A quantitative assessment of patient recruitment and
prescription data is complemented by qualitative aspects. Stakeholder
interviews and surveys identied implementation barriers and facilitators
(e.g., inner organizational structures) to derive tailored recommendations.
Discussion: Real-world conditions in heterogenous structures place high
demands on the adaptability of new care programs. Multilevel implemen-
tation strategies are necessary to enhance and maintain outreach. e
high degree of acceptance among patients and treatment teams substanti-
ates the tremendous need for a sustainable implementation of the services
provided by the AMBORA Center.
Conclusion: Based on a comprehensive evaluation of the implementation
process, we derived a best practice model of how to optimize medica-
tion safety with oral antitumor therapy in real-world clinical routine and
provide recommendations for the dissemination of the AMBORA care
program to other cancer centers.
1 Dürr et al. JCO 2021.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
239
Establishment and implementation of a multi-site Molecular
Tumor Board (MTB) at the Center for Integrated Oncology
Aachen Bonn Cologne Düsseldorf (CIOABCD)
Selina Hahn1; Lisa Fischer1; Marcel Bourgeois2,3; Lena Häberle4,5;
Georg Feldmann6,7; Udo Siebolts1,8; Martin Kirschner2,3; Verena Tischler7,9;
Simon Labuhn5,10; Wolfgang Göring4,5; Anika Schablack1;
Nadina Ortiz-Brüchle3,11; Matthias Scheer1,12
1CIO Cologne, University Hospital of Cologne, Center for Integrated Oncology
Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Deutschland
2Department of Hematology, Oncology, Hemostaseology and Stem Cell
Transplantation, Medical Faculty, RWTH Aachen University, Aachen,
Deutschland
3CIO Aachen, University Hospital RWTH Aachen, Center for Integrated Oncology
Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Deutschland
4Institute of Pathology, Heinrich Heine University & University Hospital
Düsseldorf, Düsseldorf, Deutschland
5CIO Düsseldorf, Heinrich Heine University & University Hospital Düsseldorf,
Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD),
Düsseldorf, Deutschland
6Department III for Internal Medicine, University Hospital Bonn, Bonn,
Deutschland
7CIO Bonn, University Hospital Bonn, Center for Integrated Oncology Aachen
Bonn Cologne Duesseldorf (CIO ABCD), Bonn, Deutschland
8Institute of Pathology, University Hospital of Cologne, Cologne, Deutschland,
9Institute of Pathology, University Hospital Bonn, Bonn, Deutschland
10Department of Gastroenterology, Hepatology and Infectious Diseases,
Heinrich Heine University & University Hospital Düsseldorf, Düsseldorf,
Deutschland
11Institute of Pathology, University Hospital RWTH Aachen, Aachen,
Deutschland
12Department I for Internal Medicine, University Hospital of Cologne,
Cologne, Deutschland
Background: e concept of cancer as a genomic disease has paved the
way for targeted cancer therapy. With the growing knowledge of can-
cer aberrations and the accessibility of parallel sequencing approaches,
molecular tumor boards (MTBs) have become central tools in modern
patient care. We demonstrate the feasibility of implementing and running
a multi-site MTB of the CCC CIOABCD, which consists of the university
hospitals of Aachen, Bonn, Cologne and Düsseldorf.
Methods: As all participants also run local MTBs, cases were selected
where additional discussion was deemed useful and where genomic data
was available. A “virtual” nature of the CIO MTBABCD is necessary to
overcome the geographic barriers between the four sites. Meetings were
held every two weeks. Written informed consent was obtained from all
patients.
Results: To date, 73 CIO MTBABCD have been held, with an average of
20 experts discussing the cases. In addition to oncologists, (molecular)
pathologists and molecular biologists, human geneticists, bioinforma-
ticians, organ-specic experts, and, on demand, radiologists or neu-
ropathologists participated in 100% of the CIO MTBsABCD, under the
supervision of a coordinator, due to complexity. In total, more than 1000
molecular annotated patients were presented and discussed in local MTBs
and joined CIO MTBABCD. e most frequently discussed tumor entities
were lung (25%), colorectal (15%), and head and neck cancer (10%). In
2022 a recommendation based on the molecular aberrations discussed
was given in 53%, and participation in a clinical trial was given in 37%.
In addition to the contributing centers, 51% of patients were enrolled
through collaborating regional partners by August 2023.
Discussion: e workow between the four institutions is optimized. e
CIO MTBABCD is up and running. A joined MTB registry of all four sites is
currently under construction.
Conclusion: We have established the CIO MTBABCD as a collaborative tool
and network for knowledge ow between academic centers, primary care
practices, and hospitals.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts220
305
Unraveling causes of drug resistance in BRAFV600ECRC using
single-cell mRNA sequencing of preclinical models
Anna Kotarac1,2,3,4; Lara Kunhardt von Schmidt1,4; Alexander Malt5;
Alexandra Trinks6; Hiroki Osumi7; Annalisa Lorenzato8;
Federica DI Nicolantonio8,9; Mariangela Russo8; Ryoji Yao10;
Naveed Ishaque5; Markus Morkel2,3,11,12; Alberto Bardelli8,13;
Ulrich Keilholz1,2,3; Christine Sers2,3,12; Sebastian Stintzing2,3,4;
Loredana Vecchione1,2,3,4,14
1Charité Comprehensive Cancer Center, Berlin, Deutschland
2German Cancer Consortium, Berlin, Deutschland
3German Cancer Research Center, Heidelberg, Deutschland
4Department of Hematology, Oncology, and Cancer Immunology, Campus
Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Deutschland
5BIH Center for Digital Health, Computational Oncology, Berlin Institute of
Health (BIH), Berlin, Deutschland
6Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Bioportal Single
Cells, Berlin, Deutschland
7Department of Gastroenterological Chemotherapy, Cancer Institute Hospital,
Japanese Foundation for Cancer Research, Tokyo, Japan
8Department of Oncology, University of Turin, Turin, Italien
9Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italien
10Department of Cell Biology, Cancer Institute, Japanese Foundation for Cancer
Research, Tokyo, Japan
11Berlin Institute of Health at Charité Universitätsmedizin Berlin, Bioportal Single
Cells, Berlin, Deutschland
12Department of Pathology, Charité Universitätsmedizin Berlin, Berlin,
Deutschland
13IFOM ETS, The AIRC Institute of Molecular Oncology, Milan, Italien
14Berlin Institute of Health at Charité Universitätsmedizin Berlin,BIH Biomedical
Innovation Academy, BIH Charité (Junior) (Digital) Clinician Scientist Program,
Berlin, Deutschland
Background: Chemotherapy remains the mainstay of palliative treat-
ments for BRAFV600E metastatic colorectal cancer, with limited ecacy
(1). Despite the approval of a new chemo-free regimen aer systematic
therapy, response is still poor, thus highlighting an unmet clinical need
(2,3). erefore, we aim to use single-cell mRNA sequencing (scRNAseq)
to identify transcriptional subpopulations as biomarkers of resistance to
conventional therapy.
Methods: Nine BRAFV600E CRC cell lines and ten BRAFV600E CRC
patient-derived organoids (PDOs) are being treated with the following
drugs in short term proliferation assays: erlotinib (OSI-744), encorafenib
(LGX818), 5-urouracil (5-FU), irinotecan (SN-38), oxaliplatin (L-OHP),
OSI-744+LGX818, OSI-744+SN-38, 5-FU+SN-38, 5-FU+L-OHP,
5-FU+SN-38+L-OHP. Sensitivity is being dened by IC50, AUC and
Synergy Score. Aer isolation, cell lines and PDOs at baseline and aer
treatment are being subjected to barcoding, library preparation and
sequencing (Illumina NovaSeq, 1600 mio. reads per library).
Results: Four out of ten PDO models are sensitive to OSI-744+LGX818
and one out of ten is sensitive to SN38+OSI-744. While HT29 CRC cell
line is resistant to OSI-744+LGX818, 5-FU+L-OHP, 5-FU+SN-38 and
5-FU+SN-38+L-OHP, KM20 and WiDr CRC cell lines are sensitive
to these combinations. Further drug testing in remaining models and
scRNAseq is currently ongoing. e integration of response data and
scRNAseq analysis will be validated in publicly available and in-house
clinical data sets.
Discussion: So far variable responses to drug testing have been observed.
ScRNAseq will help to identify genomic determinants of BRAFV600E heter-
ogeneity and resistance to conventional therapies.
Conclusion: To the best of our knowledge, this is the rst preclinical study
using BRAFV600E CRC preclinical models, aiming at identifying mecha-
nisms of resistance to conventional treatment currently used in clinical
practice by scRNAseq technology.
1 Kuipers et al., PMID: 27189416.
2 Tabernero et al., PMID: 33503393.
3 Middleton et al., PMID: 32047001.
Disclosure Statement: e authors declare the following: LV received research
funding and travel bursaries from Pierre Fabre.
311
German Radiation Oncologys Next Generation: A web-based
Survey of Young Biologists, Medical Physicists, and Physicians
Lisa Deloch1,2,3,4; Thomas Weissmann1,3,4; Johann Matschke5;
Sarah Stefanowicz4,6; Maximilian Grohmann4,7; Felix Ehret4,8;
Alexander Fabian4,9; Alexander Rühle4,10,11; Simone Wegen4,12;
Sebastian Lettmaier1,3; Maike Trommer4,13,14; Elena Sperk15;
Annemarie Schröder4,16
1Department of Radiation Oncology, Universitätsklinikum Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
2Translational Radiationbiology, Department of Radiation Oncology,
Universitätsklinikum Erlangen, Friedrich-Alexander-Universität
Erlangen-Nürnberg, Erlangen, Deutschland
3Comprehensive Cancer Center Erlangen-EMN, Erlangen, Deutschland
4Young DEGRO Trial Group, Berlin, Deutschland
5Institute of Cell Biology (Cancer Research), University Hospital Essen, University
of Duisburg-Essen, Essen, Deutschland
6Department of Radiation Oncology, Klinikum rechts der Isar, Technical
University of Munich (TUM), München, Deutschland
7Department of Radiotherapy and Radiation Oncology, University Medical
Center Hamburg-Eppendorf, Hamburg, Deutschland
8Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität
Berlin and Humboldt-Universität zu Berlin, Department of Radiation Oncology,
Berlin, Deutschland
9Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Kiel,
Deutschland
10Department of Radiation Oncology, University of Freiburg – Medical Center,
Freiburg, Deutschland
11Department of Radiation Oncology, University of Leipzig, Leipzig, Deutschland
12Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of
Medicine and University Hospital Cologne, Köln, Deutschland
13Department of Radiation Oncology, University of Cologne, Faculty of Medicine
and University Hospital Cologne, Köln, Deutschland
14Department of Radiation Oncology, Olivia Newton-John Cancer Wellness &
Research Centre, Austin Health, Melbourne, VIC, Melbourne, Australien
15Mannheim Cancer Center, Universitätsmedizin Mannheim, Medizinische
Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland
16Department of Radiotherapy and Radiation Oncology, University Medical
Center Rostock, Rostock, Deutschland
Background: e eld of radiation oncology (RO) is a close interconnec-
tion of multiple disciplines and has undergone a signicant change due to
new diagnostic and therapeutic developments that have revolutionized the
eld. A close, constructive collaboration of physicians, medical physicists,
and biologists is required to ensure existing and future-oriented standards.
However, during day-to-day work, the impression of a negative trend within
the workforce in RO arises, as young scientists seem to leave the eld quickly
despite active oers for career support from the (young) German scientic
organizations. Reasons for a career change may be multifactorial. We thus
aim to capture the current situation of all scientic disciplines in RO as we
intend to not only gain insight into the needs and problems of young scien-
tists but also to identify measures that can be taken for a positive turnaround
to foster a future-oriented and high-quality scientic culture in Germany.
Methods: Over a period of 6 weeks, a web-based survey was conducted
by the Trial Group from the youngDEGRO (Deutsche Gesellscha für
Radioonkologie) with members of the yDeGBS (Deutsche Gesellscha
für Biologische Strahlenforschung) and yMP (Deutsche Gesellscha für
Medizinische Physik) which included 13 generalized and 20-25 occupa-
tion-specic questions.
Results: e 218 questionnaires were completed by 89 physicians, 59 biol-
ogists, and 70 physicists. While overall satisfaction in the workforce seems
to be rather high, and the majority of participants would choose the same
career path again, several factors contribute to a decline in employee satis-
faction. Although university hospitals appear to be an attractive employer,
factors such as assurance of protected research time, especially for physi-
cians, will have to be addressed.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 221
Conclusion: A large interest in a close interdisciplinary collaboration is
evident, opening up opportunities for intensied, high-quality transla-
tional research and joint eorts to maintain and expand future compe-
tence within RO in Germany.
LD, TW contributed equally
Disclosure Statement: e authors declare the following: LD, Supported by the
BMBF (TOGETHER, 02NUK073; GREWIS, 02NUK017G, GREWIS-alpha,
02NUK050E); JM, Supported by the BMBF (02NUK061B), MT, Supported by the
Koeln Fortune Program / Faculty of Medicine, University of Cologne.
331
Breite Onkologische Versorgung im digitalen Kreislauf der
Wissen generierenden Versorgung
Wolfgang Knauf; Thomas Illmer; Nils Dreiack; Jana Becker;
Armin Goetzenich
Berufsverband der niedergelassenen Ärztinnen und Ärzte für Hämatologie und
Medizinische Onkologie (BNHO e.V), Köln, Deutschland
At the inception of knowledge-driven care in the outpatient sector,
molecular diagnostics play a pivotal role within a structured framework.
Recent advancements in this eld have signicantly improved the accu-
racy of describing oncological conditions. is marks the initiation of
a reciprocal cycle between healthcare delivery and research, poised to
yield substantial progress in tumor patients survival and disease manage-
ment through targeted applications in the forthcoming years. Enhancing
cross-sectoral oncological standard care necessitates seamless collabora-
tion among regional and supra-regional care structures, including onco-
logical centers, organ cancer centers, certied hospitals, local hospitals,
general practitioners, practicing oncology specialists, nursing services,
patient representatives, and the patients themselves. e primary goal of
this approach is to provide cancer patients with access to modern molec-
ular diagnostics while also utilizing the acquired data as a foundation for
further oncological research. Furthermore, the approach aims to be inte-
grated as a structured system within the healthcare framework:
Patient Access: Ensuring cancer patients access to quality-assured and
certied NGS or WGS diagnostics, primarily carried out in CCC or within
the network centers of nNGM.
MTB: Convened when decisions cannot be made based on available
guideline recommendations. e interpretation of molecular ndings and
proles of individual diseases necessitates collaboration among specialists
from various disciplines.
Databases and Evaluation: Establishing databases that systematically
document patient core data, medical history, diagnosis, tumor histology,
molecular diagnostic data, treatment, and progression data (DigiNet)
PRO: Collecting PRO data for comprehensive evaluation of process and
outcome quality, addressing patient-specic inquiries.
Research Integration: Providing information and recommendations
derived from research studies, complementing the evidence-based ther-
apeutic recommendations of MTBs.
Disclosure Statement: e authors declare no conict of interest.
433
NMR-based GFR measurement in patients on high-dose
methotrexate
Sabine Einhell1; Amauri Schwäble Santamaria2; Andrew Robertson2;
Marcello Grassi2; Tobias Pukrop1; Eric Schier2
1Universitätsklinikum Regensburg, Regensburg, Deutschland
2Numares AG, Regensburg, Deutschland
Background: In the context of hemato-oncological therapies, nephro-
toxic drugs such as methotrexate (MTX) play an important role. Since
its delayed excretion can lead to severe side eects, close monitoring with
surveillance of renal function is necessary. In clinical practice, this is done
by determining eGFR by creatinine, which, however, is of limited use in
oncological and elderly patients due to reduced muscle mass/sarcopenia.
For this reason, an alternative GFR determination via NMR measurement
was investigated in this work in collaboration with the numares AG.
Methods: To date, 29/30 patients with acute lymphoblastic leukemia or
(CNS-) lymphoma who received high-dose MTX as part of their guide-
line-guided therapy have been included. Serum was obtained at 4 dierent
time points -before MTX-, 24, 42 and 48 h aer the start of MTX admin-
istration-, measured by NMR in 5-fold replicates and compared with the
commonly used GFR measurements eGFRCr (CKD-EPI (Chronic Kidney
Disease Epidemiology Collaboration) creatinine) and eGFRCrCys (CKD-
EPI creatinine cystatin).
Result: Initial analysis (9 patients, 13 cycles) showed that NMR meas-
urements were not aected by MTX. During the course of MTX applica-
tions, a 1.5- to 2-fold increase in creatinine was detected in 1 patient aer
eGFRCr according to AKIN criteria (stage 1). eGFRNMR best reected MTX
plasma clearance with r=0.758 (95% CI 0.36-0.92, p=0.004) compared
to CKD-EPICr (r=0.401, 95%CI -0.19-0.78, p=0.176) and CKD-EPICrCyc
(r=0.632, 95% CI 0.12-0.88).
Discussion: e dose reductions of drugs frequently required in clinical
practice due to impaired renal function aect patient response to therapy
and survival. More precise estimation of GFR may allow better individu-
alization for each patient.
Conclusion: In the context of MTX therapies, monitoring of GFR is
possible via NMR technique, which, compared to conventional methods,
better reects MTX clearance.
Indication of source: AACC 2023 Poster.
Disclosure Statement: e authors declare no conict of interest.
468
Advancing Precision Oncology: Integration of Onco-PDO Test
for Rapid Drug Response Proling in Breast Cancer
Patient-Derived Organoids
Zahra Dantes1; Jolanta Slawska1; Apoorva Manjunath1;
Sandra Zormaier1; Anja Steininger1; Florian Mandlmeier1;
Luciana Ferreira1; Linda Huang2; Katja Steiger3; Nicole Pfarr3;
Marion Kiechle4; Kathrin Lindner1; Wilko Weichert3; Christian Peschel5;
Stefan Paepke4
1Invitrocue Europe AG, München, Deutschland
2Invitrocue Hong Kong Ltd, Hong Kong SAR, China, VR
3Institue of Pathology, Technical University of Munich (TUM), München,
Deutschland
4Department of Gynecology, Technical University of Munich (TUM), München,
Deutschland
5Technical University of Munich (TUM), München, Deutschland
Background: Since patient-derived organoids (PDOs) can potentially
serve as a preeminent model for precision oncology, we aimed to con-
duct a prospective exploratory study to generate PDOs from dierent
subtypes of breast cancer (BC) patients for further characterization and
drug screening.
Methods: Aer PDO generation, expansion, and biobanking, PDOs were
compared with matched primary tumor tissue histologically and genom-
ically. Furthermore, the Onco-PDO test, an established drug screening
assay by Invitrocue, was performed in a clinically meaningful timeframe
of 10-14 days to assess PDO drug response. e clinical correlation anal-
ysis between the patients response and the matched PDO drug response
is ongoing.
Result: us far, 91 tumor tissues from the primary tumor (PT; N=68) and
lymph node metastases (LN; N=23) were collected from 77 BC patients
enrolled in our study in the Invitrocue Munich laboratory. irteen sam-
ples were taken from PT and matched LN metastasis. e PDOs were
successfully generated from 82 samples and established in 67 cases (suc-
cess rate: 90.1% and 81.7%, respectively). e Onco-PDO test, including
standard-of-care chemotherapeutics, molecular targeted drugs, CDK4/6
inhibitors, and hormone therapy in 67 samples (PT: 55, LN: 12), resulted
in 1191 readouts with high heterogeneity. Genetically and histopathologi-
cally, PDOs showed strong similarities to primary tumors.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts222
Discussion: e Onco-PDO drug testing, encompassing a comprehensive
panel of therapeutics, revealed substantial drug response diversity among
PDOs. is heterogeneity signies the intricacies of individual patient
responses, which can have profound implications for personalized treat-
ment strategies.
Conclusion: Our ndings indicate that BC-PDOs can be generated from
a small biopsy, and the Onco-PDO drug testing can be performed in a
clinically meaningful timeline of <14 days to identify the responder and
non-responder PDOs towards each treatment and potentially minimize
side eects from unnecessary treatments and may allow a better predic-
tion of tumor response.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
531
Optimizing generation of patient derived cancer organoids
for informed clinical decision making
Yazid J. Resheq1; Johann Gout2; Jessica Lindenmayer3; Mark Hänle1;
Thomas J. Ettrich1; Lukas Perkhofer1,2; Thomas Seuerlein1;
Alexander Kleger1,2,3
1Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm, Deutschland
2Institut für Molekulare Onkologie und Stammzellbiologie, Universitätsklinikum
Ulm, Ulm, Deutschland
3Core Facility Organoids, Universität Ulm, Ulm, Deutschland
Background: Patient derived organoids (PDOs) are likely to advance per-
sonalized oncology as they recapitulate patient-individual tumors, incl.
pancreatic cancer (PC). For this purpose, reliable reproducibility, time-,
labor- and cost-ecient procedures are required.
Methods: roughout implementation of the Core Facility Organoids
at Ulm University, we established advanced culture techniques/proto-
cols optimized for automation and standardization (i.e. pipetting robot,
downscaling to a 384-well culture system). Additionally, we downscaled
the number of cells required for pharmacotyping. To assess tumor evolu-
tion, longitudinally obtained PDO-pairs from 7 patients were analyzed by
whole exome sequencing (WES).
Results: Automation-optimized culture techniques accelerated
patient-individual phamacotyping from a “hands-on” median of 52 days
to 33 days. By adapting and standardizing of earlier protocols we achieved
an improved rate of PC-PDOs eligible for pharmacotyping from 52% to
80%. We observed a correct correlation of PDO-drug-response and clin-
ical outcome in 86% of treatment-naïve PC-patients also translating into
longer PFS in case of correct prediction of sensitivity in the PDO-culture
to a certain regimen. However, correct correlation decreased to 57% in
PDOs established from pretreated patients. On WES we observed a lower
mutational burden and amount of nonsynonymous mutations following
chemotherapy. Of note, we identied a CHEK2-mutated patient featuring
long-term response to a PARP inhibitor.
Discussion: Due to structured, automated, and standardized processes
in our Core Facility we advanced our PDO-assays to potentially translate
into a prediction tool to guide treatment for distinct patient cohorts.
Conclusion: PDOs may be employed to guide personalized treatment in
a standardized and comprehensive facility. Nevertheless, several achieve-
ments are required for clinical applicability such as bio-printed 3D-models
and prospective clinical trials to prove validity.
Disclosure Statement: e authors declare no conict of interest.
590
Functional role of tumor-specic B cells and tertiary-lymphoid
structures in preclinical models of immune checkpoint
therapy
Jonas Lehmann1; Martin Thelen1; Maria Garcia-Marquez1;
Pauline Volkmar1; Klara Siepmann1; Therese Seidlitz2; Daniel Stange2;
Philipp Fervers3; Thorsten Persigehl3; Christiane J. Bruns4; Michael von
Bergwelt-Baildon5; Kerstin Wennhold1; Hans Schlößer1,4
1Center for Molecular Medicine Cologne (CMMC), Köln, Deutschland
2Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Deutschland
3Uniklinik Köln, Radiology, Cologne, Cologne, Deutschland
4Uniklinik Köln, Department of General, Visceral, Cancer and Transplantation
Surgery, Cologne, Deutschland
5LMU München, Department of Internal Medicine III, Munich, Deutschland
Background: Immune checkpoint inhibition (CKI) demonstrated break-
through therapeutic ecacy in a variety of cancer types. Recent data
suggest an important role of B cells and tertiary-lymphoid structures for
susceptibility of cancer patients to CKI.
Methods: To advance our understanding of B cell specic mechanisms
in the setting of CKI, we used two genetically modied mouse models,
which express a tamoxifen-inducible Cre-recombinase in the stomach-spe-
cic Anxa10 locus. e genomically stable (GS) cancer model (Cdh1/,
KrasG12D/+ and Smad4/) demonstrates a slow progressing tumor growth as
observed by magnetic resonance imaging (MRI). e chromosomally insta-
ble (CIN) model (KrasG12D/+, Tp53R172H/+ and Smad4/f) shows a more rapid,
intestinal tumor growth. For study of antigen-specic immune responses,
we included the subcutaneous PancO2-OVA tumor model. All three mouse
models received single or combination CKI with anti-PD-1 and anti-4-1BB.
Result: CKI in the PancO2-OVA model resulted in a signicant increase
of OVA-specic B cells and secretion of OVA-specic antibodies. is
was accompanied by an increase of Tfollicular helper cells and activated
CD86+ B cells. e genetically modied cancer models developed metas-
tases in liver, lymph nodes and lungs at later stages. We detected B-cell
clusters in the tumor microenvironment indicating the presence of ter-
tiary-lymphoid structures. In the GS model, combination therapy with
anti-PD1 and anti-4-1BB did not result in a signicant reduction of tumor
growth. However, we observed increased percentages of memory B cells,
germinal center B cells, activated CD86+ B cells and activated T-cell sub-
populations. Results of the CIN model will be presented as well.
Discussion: TLS are usually not observed in cancer mouse models, thus
the here described gastric cancer models oer a unique opportunity to
study TLS formation. CKI seems to increase the anti-tumor B-cell response
by enhanced antigen presentation and humoral-immune response.
Conclusion: Our results underline the role of B cells in CKI.
Disclosure Statement: e authors declare no conict of interest.
600
Humanized mouse models for the preclinical evaluation of
novel immune cell therapies, check point inhibitors, and
immune cell engagers
Maria Stecklum1; Annika Wulf-Goldenberg1; Joshua Alcaniz1;
Bernadette Brzezicha1; Walther Wolfgang1,2; Jens Homann1
1EPO GmbH, Berlin, Deutschland
2ECRC, Charité Universitätsmedizin Berlin, Berlin, Deutschland
Background: e preclinical evaluation of novel immune therapies
requires humanized mouse models with functional human immune cells.
In previous studies we have demonstrated, that either peripheral blood
mononuclear cells (PBMC), subsets of PBMCs like T- and NK-cells
or hematopoietic stem cells (HSC) can be used to establish a human-
ized immune system. By transplantation of cell-line-derived (CDX) or
patient-derived (PDX) tumors on humanized mice, we successfully gener-
ated a full human tumor-immune-cell model for dierent disease entities.
Finally, we validated the functionality of these models using checkpoint
inhibitors (CPI) like Nivolumab, and immune cell engagers (ICE).
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 223
Methods: HSC-humanized mice were generated by i.v. transplantation of
HSC to 1st and 2nd generation NOG mice. Engrament of immune cells
was monitored by FACS analysis of blood samples. PBMC or isolated T-
or NK-cell preparations were used to humanize mice by single or mul-
tiple i.v. injections. CDX and PDX from dierent entities were s.c.(i.e.
lymphoma) and/or i.v.(leukemia) transplanted on those humanized mice.
Tumor growth of i.v. models was followed up by BLI measurement.
Results: e transplanted HSCs engraed in mice and established a func-
tional human immune system. e 2nd generation NOG mice are show-
ing an increased total engrament and lineage specic dierentiation.
e selected CDX and PDX tumors successfully engraed on humanized
mice without signicant dierences in tumor growth compared to non-
humanized mice. CPI treatments induced tumor growth delay in selected
models. BLI is a suitable method to follow up systemic disease models and
treatment eects over time.
Conclusions: We established human tumor-immune-cell models of dif-
ferent entities using CDX or PDX in combination with dierent immune
cell subsets. ese models have been successfully used for preclinical eval-
uation of novel CPI, cell therapies and ICE. Our models allow preclinical
translational research on tumor immune biology as well as evaluation of
new therapies, drug combinations and biomarker identication.
Disclosure Statement: e authors declare the following: Angestellter, CSO oder
CEO von EPO GmbH.
732
Exploiting somatic oncogenic driver alterations in a patient
with Li-Fraumeni-Syndrome – Paving the path towards
precision medicine
Carolin Seeling1; Sonja Dahlum2; Ralf Marienfeld3; Vera Hallebach2;
Brigitte Rack4; Uwe Gerstenmaier3; Ambros Beer5;
Regine Mayer-Steinacker1; Wolfgang M. Thaiss5; Thomas Barth3;
Thomas Seuerlein6; Nadine T. Gaisa3; Stephan Stilgenbauer1;
Wolfgang Janni4; Hartmut Döhner1; Reiner Siebert2; Verena Gaidzik1
1Klinik für Innere Medizin III, Universitätsklinikum Ulm, Ulm, Deutschland
2Institut für Humangenetik, Universitätsklinikum Ulm, Ulm, Deutschland
3Institut für Pathologie, Universitätsklinikum Ulm, Ulm, Deutschland
4Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm,
Ulm, Deutschland
5Klinik für Nuklearmedizin, Universitätsklinikum Ulm, Ulm, Deutschland
6Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm, Deutschland
Background: Li-Fraumeni-Syndrome (LFS), resulting from pathogenic
germline TP53 variants, represents an inherited cancer susceptibility dis-
order (CSD). Due to impaired DNA damage repair, conventional cyto-
toxic therapies or radiotherapy contribute to high incidence of treatment
related secondary malignancies in these patients.
Methods: Germline analysis was performed from blood DNA using the
TruRisk-Gene-Panel (Illumina). e OncoScan Assay (Aymetrix) and
TMB-NGS-Panel (Illumina) were implemented to identify somatic muta-
tions in the tumor tissues. Genetic proles were interpreted in our molec-
ular and familial tumor board (MoFa) of the Comprehensive Cancer
Center Ulm to provide individual treatment recommendations.
Result: We report the case of a woman with history of breast cancer and
subsequent osteosarcoma (OS), both tumors treated with surgery and
chemotherapy. Due to the tumor history of the patient, genetic testing
was initiated, which revealed a pathogenic TP53 germline variant. Hence,
chemotherapy for OS was stopped and next generation sequencing as well
as OncoScan copy number variation array analysis of the osteosarcoma
tissue were initiated in our MoFa. A homozygous loss of 9p21, harboring
the CDKN2A gene locus, was identied, providing rationale for a treat-
ment with CDK4/6 inhibitor Palbociclib. Aer 2 years Palbociclib was
terminated with no evidence of disease. One year later ovarian cancer was
diagnosed. OncoScan analysis of this ovarian cancer revealed copy num-
ber loss of the BRCA2 gene locus in 13q and a targeted therapy with the
PARP-inhibitor Olaparib was initiated recently.
Discussion: is case report corroborates that genotoxic therapies should
be avoided whenever feasible to reduce the risk of multiple primary tum-
ors in patients with LFS. e identication of additional somatic driver
mutations in LFS tumors provides the basis for targeted and nongenotoxic
therapies.
Conclusion: Early case evaluation by a multidisciplinary MoFa is critical
to increase the awareness of molecular proling and targeted therapies in
patients with CSDs.
Disclosure Statement: e authors declare no conict of interest.
761
MACC1 is a Novel Prognostic Biomarker in Pseudomyxoma
Peritonei and Induces Migration and Drug Resistancein vitro
Matylda Zoa Kuzinska1,2; Safak Gül-Klein1; Dennis Kobelt2,3;
Viktoria Zinnow2; Pia Herrmann2; Nina Heisterkamp2; Sandra Wegel1;
Annette Torgunrud4; Kjersti Flatmark5,6; Wolfgang Walther2; Beate Rau1;
Ulrike Stein2,3
1Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Campus Charité
Mitte und Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin,
Berlin, Deutschland
2Translationale Onkologie Solider Tumore, Experimental and Clinical Research
Center, Charité - Universitätsmedizin Berlin und Max-Delbrück Zentrum für
Molekulare Medizin in der Helmholz-Gemeinschaft, Berlin, Deutschland
3Deutsches Konsortium für Translationale Krebsforschung, Heidelberg,
Deutschland
4Department of Clinical and Molecular Medicine, Norwegian University of
Science and Technology, Trondheim, Norwegen
5Department of Tumor Biology, Institute for Cancer Research, Norwegian
Radium Hospital, Oslo University Hospital, Oslo, Norwegen
6Section for Surgical Oncology, Norwegian Radium Hospital, Department
ofGastroenterological Surgery, Oslo University Hospital, Oslo, Norwegen
Background: Metastasis-associated in colon cancer-1 (MACC1) is a val-
uable biomarker for a variety of solid tumors. However, there is no data
concerning its role in Pseudomyxoma peritonei (PMP), a rare malignancy
of the peritoneum characterized by mucinous ascites and implants in the
abdominal cavity.
Methods: MACC1 circulating RNA was quantied in 68 serum samples
from PMP patients using qRT-PCR. Aer stratifying the samples into
a low- and high-MACC1 group, the patients’ clinical parameters were
correlated with MACC1 levels. Additionally, the only two commercially
available PMP cell lines with low endogenous MACC1 levels have been
transduced to establish MACC1 overexpressing models; the inuence of
MACC1 on the cell phenotype and response to cytostatics has been inves-
tigated using proliferation-, migration-, and apoptosis assays.
Result: Patients with high plasma levels of MACC1-RNA displayed sig-
nicantly worse postoperative survival rates as compared to patients with
low MACC1 levels (48 months vs. not reached at 31 months, p=0.033); a
similar trend was observed in terms of overall survival (78 months vs. not
reached at 45 months, p=0.071). No correlation was observed between
MACC1 levels and tumor grade, disease burden and RAS mutation status.
In comparison to control cells, MACC1-transduced PMP cells showed
increased proliferation- and migration rates and decreased sensitivity to
cisplatin and mitomycin C.
Discussion: MACC1 is a candidate prognostic biomarker in PMP; further
evaluation as a diagnostic biomarker by comparison with a control group
is required. e MACC1-induced changes in cellular phenotype and ther-
apy response imply its important role in disease progression, highlighting
its role as a potential therapeutic target.
Conclusion: Incorporating circulating MACC1 transcripts into the exist-
ing clinical workup could improve the accuracy of prognosis prediction in
PMP patients. Further investigation of MACC1 in PMP may help identify
new molecular therapy targets for this disease.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts224
764
Synergism of Glutamine Metabolism and NFATc1 and its
potential for enhanced therapeutic ecacy in PDAC
Laura Melissa Huhnold1; Zurine Bonilla del Rio1; Sercan Mercan1;
Reutlinger Kristina1; Christine Gibhardt2; Angela Boshnakovska3;
Sabrina Sulzer1; Jacob Hamm1; Peter Rehling3; Ivan Bogeski2; Umair Latif1;
Volker Ellenrieder1
1University Medical Center Goettingen, Clinic of Gastroenterology,
gastrointestinal Oncology and Endocrinology, Goettingen, Deutschland
2University Medical Center Goettingen, Molecular Physiology, Institute of
Cardiovascular Physiology, Goettingen, Deutschland
3University Medical Center Goettingen, Department of Cellular Biochemistry,
Goettingen, Deutschland
Background: Pancreatic ductal adenocarcinoma (PDAC) is known to be
aggressive and chemoresistant. Evidence suggests that metabolic rewiring
promotes these features. However, the underlying mechanisms that sup-
port tumor progression in a nutrient-poor environment and its clinical
implications remain elusive. Our aim was to dene the role of the Nuclear
Factor of Activated T-Cells 1 (NFATc1) to the hallmarks of metabolic
reprogramming and survival mechanisms in PDAC.
Methods: We employed in vitro experiments using human and murine
PDAC cell lines, patient-derived-xenogras and organoids to determine
gene regulation, cellular stress responses, metabolism and chemoresis-
tance. Quantitative, functional and molecular characterization was per-
formed in concert to nutrient-depleted conditions, chemotherapeutics
and signaling inhibition of Glutaminase and NFATc1.
Result: NFATc1 highly correlates to the expression and activity of key
enzymes in glutamine catabolism, e.g. alpha-ketoglutarate dehydroge-
nase, leading to enhanced oxidative phosphorylation and glutathione
requirements. Moreover, the presence of glutamine eects the expres-
sion of NFATc1, whereas loss of NFATc1 facilitates adaptation to nutrient
deprivation. Finally, inhibition of NFATc1 or its mediated pathways show
increased vulnerability to chemotherapeutic agents.
Discussion: Our ongoing study suggests that NFATc1 controls remod-
eling of metabolism, resulting in the addiction to glutamine. Aside the
role of NFATc1 in cellular stress responses, its involvement in anaple-
rotic reactions might provide a potential therapeutic target for the
aggressive NFATc1high subtype of PDAC by disrupting its metabolic bal-
ance in addition to antineoplastic drugs. Further studies will investigate
these ndings in vivo.
Conclusion: We demonstrate that progression and resistance of PDAC
is linked to NFATc1 through stress responses and metabolic reprogram-
ming, which orchestrates a theoretical platform for tailored treatment
strategies.
Disclosure Statement: e authors declare no conict of interest.
770
The synergy between the agent GP-2250 and Gemcitabine as
a new maintenance therapy approach for pancreatic cancer
ina PDX mouse model
Britta Majchrzak-Stiller1; Marie Buchholz1; Ilka Peters1; Stephan Hahn2;
Johanna Strotmann1; Thomas Müller3; Waldemar Uhl1; Chris Braumann4;
Phillip Höhn1
1St. Josef Hospital Universitätsklinikum der Ruhr-Universität Bochum Klinik für
Allgemein- u. Viszeralchirurgie Arbeitsgemeinschaft Molekulare und Klinische
Forschung, Bochum, Deutschland
2Ruhr-Universität Bochum Zentrum für Klinische Forschung (ZKF) Labor
für Molekulare Gastroenterologische Onkologie (MGO) der Medizinischen
Universitätsklinik Knappschaftskrankenhaus, Bochum, Deutschland
3Geistlich Pharma AG, Wolhusen, Schweiz
4Department of General, Visceral and Vascular Surgery, Evangelische Kliniken
Gelsenkirchen, Akademisches Lehrkrankenhaus der Universität Duisburg-Essen,
Gelsenkirchen, Deutschland
Background: e substance GP-2250, a novel Oxathiazinane deriv-
ative previously showed antineoplastic activity in vitro and in vivo in
pancreatic cancer cells and in patient-derived mouse xenogras (PDX)1.
e substance is currently under Phase I clinical trial (clinicaltrials.gov:
NCT03854110) in pancreatic ductal adenocarcinoma (PDAC).
Methods: In this study, we now show a high synergistic capacity of
GP-2250 in combination with Gemcitabine in a pancreatic cellline -and
PDX-model setting.
Result: In vitro, a minor active dose of GP-2250 combined with an inac-
tive dose of Gemcitabine showed almost a doubled cytotoxicity compared
to GP-2250 monotherapy in dierent pancreatic cancer cells (established
and primary lines). ese results were conrmed in our rst line in vivo
study, where this drug combination was superior in reducing tumor vol-
ume compared to Gemcitabine alone in all eight PDX-models. Further,
a combination of GP-2250 and Gemcitabine was able to induce a par-
tial remission of tumor volume in four of eight, and a stable disease in
in three of eight PDX models. Gemcitabine monotherapy was associated
with progressive disease in all PDX except one. In a subsequent mainte-
nance setting following two weeks of treatment with nab-Paclitaxel plus
Gemcitabine, four PDX showed partial reduction and three showed a sta-
ble disease, whereas Gemcitabine in monotherapy resulted in progressive
disease in six of eight PDX models.
Discussion: e results proved this combination therapy to be highly
eective on both, established cells and primary cell lines, as well as in vivo
on PDX models of PDAC while retaining a low toxicity prole.
Conclusion: In view of its high tolerability, the use of the GP-2250/
Gemcitabine combination in maintenance therapy following nab-Pacli-
taxel/Gemcitabine as rst-line treatment appears as a highly promising
drug combination therapy.
1. Buchholz M. et.al. Innovative substance 2250 as a highly promising
anti-neoplastic agent in malignant pancreatic carcinoma - in vitro and in vivo.
BMC cancer 2017;17:216.
Disclosure Statement: e authors declare the following: Forschungskooperation.
776
Increasing the cytotoxic eectivity of 5FU, Irinotecan and
Oxaliplatin on pancreatic cancer cells through combination
with the novel anticancer agent GP-2250 in vitro
Ilka Peters1; Britta Majchrzak-Stiller1; Marie Buchholz1; Philipp Höhn1;
Thomas Müller2; Waldemar Uhl1; Chris Braumann3; Johanna Strotmann1
1Department of General and Visceral Surgery, St. Josef-Hospital, Ruhr-University
Bochum, Bochum, Deutschland
2Geistlich Pharma AG, Wolhusen, Schweiz
3Department of General, Visceral and Vascular Surgery, Evangelisches
Krankenhaus Herne, Akademisches Lehrkrankenhaus der Ruhr-Universität
Bochum, Herne, Deutschland
Background: e oxathiazinan derivative GP-2250 has a selective cyto-
toxic eect on various tumor entities in vitro and in vivo. As part of a
clinical Phase I trial, the substance is currently administered in combina-
tion with Gemcitabine aer FOLFIRNOX treatment. Especially in combi-
nation with Gemcitabine, GP-2250 showed a distinct synergy, enhancing
the eectivity of Gemcitabine and reducing the occurrence of secondary
resistances, without amplication of adverse events in vivo [1].
Methods: To evaluate, if GP-2250 might also enhance the eciency
of the FOLFIRINOX Regimen, the cytotoxicity of 5FU, Irinotecan
and Oxaliplatin in combination with GP-2250 was evaluated in vitro.
Pancreatic cancer cell lines were seeded for an MTT cytotoxicity assay
and treated with the single substances and their combinations. Aer incu-
bation time of 48 h, the cell viability was measured and the synergy was
evaluated according to the Chou-Talalay combination index.
Result: Combination of GP-2250 with all three chemotherapeutic sub-
stances did indeed increase their cytotoxic eect signicantly and dis-
played a promising synergism.
Discussion: is indicates that GP 2250 may also be a promising option
to improve the eectivity of the FOLFIRINOX regimen.
Conclusion: e results form a solid foundation for further in vivo stud-
ies to validate the synergy and to get a rst assessment of the toxicity.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 225
Reference:
1 Buchholz, M. and Strotmann, J et al.: New erapy Options for
Neuroendocrine Carcinoma of the Pancreas—e Emergent Substance
GP-2250 and Gemcitabine Prove to Be Highly Eective without the
Development of Secondary Resistances In Vitro and In Vivo. Cancers 2022, 14,
2685. https://doi.org/10.3390/cancers14112685.
Disclosure Statement: e authors declare the following: Forschungskooperation.
792
Human patient-derived organoid model as a promising tool
to study cytotoxic treatment eects on glioblastoma cells:
atechnical note
Meng-Chun Hsieh1; Ahmad Melhem1; Barbara E. F. Pregler1; Andreas Dolf2;
Andreas Waha3; Torsten Pietsch3; Hartmut Vatter1; Michael Hölzel4;
Ulrich Herrlinger5; Anna-Laura Pottho1; Matthias Schneider1
1Department of Neurosurgery, University Hospital Bonn, Bonn, Deutschland
2Flow Cytometry Core Facility, Medical Faculty, University of Bonn, Bonn,
Deutschland
3Department of Neuropathology, University Hospital Bonn, Bonn, Deutschland
4Institute of Experimental Oncology, University Hospital Bonn, Bonn,
Deutschland
5Division of Clinical Neuro-Oncology, Department of Neurology, University
Hospital Bonn, Bonn, Deutschland
Introduction: Tumor organoid models have emerged as a powerful tool
in cancer research. By avoiding clonal selection and preserving the tumor’s
local cytoarchitecture, three-dimensional organoids provide a more phys-
iologically relevant platform for studying the heterogeneity of cancer cells
and drug responses. However, valid methodological approaches for cell
death analyses applying ow cytometry are lacking. Using glioblastoma
organoids (GBOs) as an exemplary tumor model, we developed a protocol
to measure cell death as an important readout in cancer research.
Materials and Methods: Human GBOs were generated out of patient-
derived tumor material from neurosurgical resections. Temozolomide
(TMZ) and lomustine (CCNU) were used as cytotoxic agents commonly
employed in glioblastoma therapy. A protocol - originally published by
Nicoletti et al. for cell culture monolayers – was rened to assess cell death
in GBOs using ow cytometric analysis of propidium-iodide (PI)-stained
nuclei. Specic DNA fragmentation rates served as a surrogate readout
for cell death. Hoechst 33258 staining was utilized as a validation tool for
the adapted protocol.
Results: Aer treatment of 288 hours with physiologically-relevant
concentrations of TMZ and CCNU, DNA fragmentation rates in the
subG1-peak reached up to 65%. e results were consistent between both
biologic and technical replicates. Hoechst staining conrmed cell death
rates obtained from PI-based uorescence activated cell sorting analysis.
Discussion: Further improvements are needed to enable cell sorting for
immune and endothelial cells to perform readout analysis specically for
the tumor cell fraction in GBOs.
Conclusions: e rened Nicoletti protocol is a feasible and valid tool to
quantify cell death rates under dierent treatment conditions in organoids
using ow cytometry.
Disclosure Statement: e authors declare no conict of interest.
801
Categorization of Variants of Uncertain Signicance(VUS)
byDNA repair and replication assays
Benedikt Heitmeir; Miriam Deniz; Wolfgang Janni; Rebecca Jansche;
Lisa Wiesmüller
Universitätsfrauenklinik Ulm, Ulm, Deutschland
Background:. Today risk gene detection fully relies on the use of
NG-Sequencing, resulting in large numbers of variants of unknown
signicance (VUS). One core challenge therefore is to categorize newly
identied risk gene variants to accurately counsel the respective patients.
TP53 is a risk gene with high penetrance, underscoring the importance
of eorts to categorize TP53 VUS. While several assays based on canoni-
cal functions have been engaged a multitude of variants remained where
these assays oen produced inconclusive or contradictory data.
Methods: Our goal is to classify VUS of TP53 through DNA repair and
replication assays, by focusing on novel and underexplored non-canon-
ical functions of TP53. us, we are examining the prociency of VUS
to bypass replication barriers as compared to non-pathogenic and patho-
genic variants by (i) measuring the track length of nascent DNA synthesis
via DNA Fiber Assay, and (ii) quantication of recombination mediated
bypass of replication barriers via our established uorescence-based
reporter assay.
Result: We have been able to show a highly signicant dierence in DNA
ber track length between the dierent wild-type and pathogenic variants.
is is caused by a bypass of replication barriers via translesional DNA
replication which is faster than fork remodelling, yet mutagenic. ese
results are mirrored in our reporter-based assay where we were able to
show corresponding dierences in the frequency of the recombination
mediated-bypass in wild-type-like and pathogenic variants of TP53.
Discussion: We have been able to detect the impaired function in TP53
variants even when canonical assays fail. To further our goal of classify-
ing these VUS we are examining the complete spectrum of German TP53
variants. Our research has already led to the reclassication of one likely
pathogenic VUS providing access to intensive clinical care program.
Conclusion: We have been able to establish novel assays for improved
classication of previously enigmatic TP53 variants by exploiting so far
underexplored non-canonical functions of p53.
Disclosure Statement: e authors declare no conict of interest.
827
Mistletoe extracts inhibit colorectal cancer cell growth in vitro
Sebastian Wolfshöfer1; Martina Gast1; Friedemann Schad2;
Sebastian Stintzing1; Patricia Grabowski1,2
1Charité Campus Mitte - Charité Campus Mitte - Medizinische Klinik m.S.
Hämatologie, Onkologie und Tumorimmunologie, Berlin, Deutschland
2Gemeinschaftskrankenhaus Havelhöhe Klinik für Anthroposophische Medizin,
Berlin, Deutschland
Background: Colorectal cancer is the second most common cause of
cancer-related deaths worldwide and among the most frequently diag-
nosed cancers in Germany. Adjuvant chemotherapy is standard treatment
aer surgical removal of primary tumors, but development of resistance
is common. Administration of mistletoe (Viscum album) extracts can
improve quality of life for patients, by reducing side eects of treatment
with chemotherapeutic agents. ese extracts demonstrate immunomod-
ulatory properties, which have the potential to improve the eectivity of
anti- tumor therapy. Furthermore, in vitro experiments suggest a direct
eect on growth of colorectal cancer cells. However, the underlying
intra-cellular processes and modulated pathways have not been analyzed
suciently.
Methods: e eects of two mistletoe extracts, HelixorA® (host: r) and
Helixor M® (host: apple tree), on cell viability were assessed by MTT assay
in six dierent colorectal cancer cell lines. Cell cycle was analyzed by ow
cytometry. Multiplex gene expression analyses were conducted to assess
involved signaling pathways and key results were validated on protein
level by western blot analysis.
Result: Both mistletoe extracts were able to decrease cell viability in all
six investigated colorectal cancer cell lines. SW480 and Caco2 cells were
most susceptible to both extracts. e combination of mistletoe extract
to 5-FU therapy reduced cell viability by additional 50% in SW480 cells
and by 30% in Caco2 cells, indicating an additive eect. Gene expression
analysis highlighted the involvement of Myc signaling. e reduction of
c-Myc protein levels was conrmed in both cell lines.
Discussion: We demonstrated that mistletoe extracts can inhibit prolifer-
ation in colorectal cancer cells alone and in combination with 5-FU. Our
results implicate a role of c-Myc reduction in the antiproliferative eects
caused by mistletoe extracts.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts226
Conclusion: Further research in vitro and in vivo is needed to investigate the
potential of mistletoe extracts as direct therapeutic agents in colorectal cancer.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
862
DanioCTC: Analysis of circulating tumor cells from metastatic
breast cancer patients in zebrash xenografts
Florian Reinhardt1; Luisa Coen1; Mahdi Rivandi1; André Franken1;
Eunike Setyono2,3; Tobias Lindenberg4; Jens Eberhardt5; Tanja Fehm1;
Dieter Niederacher1; Franziska Knopf2,3; Hans Neubauer1
1Department of Obstetrics and Gynecology, Heinrich Heine University of
Duesseldorf, Duesseldorf, Deutschland
2Center for Regenerative Therapies TU Dresden (CRTD), Center for Molecular
and Cellular Bioengineering (CMCB), TU Dresden, Dresden, Deutschland
3Center for Healthy Aging, Faculty of Medicine Carl Gustav Carus, TU Dresden,
Dresden, Deutschland
4Anatomical Institute, Neuroanatomy, Medical Faculty, University of Bonn,
Bonn, Deutschland
5ALS Automated Lab Solutions GmbH, Jena, Deutschland
Circulating tumor cells (CTCs) serve as crucial metastatic precursor
cells, but their study in animal models has been hindered by their low
numbers. To address this challenge, we present DanioCTC, an innova-
tive xenogra workow that overcomes the scarcity of patient-derived
CTCs in animal models. By combining diagnostic leukapheresis (DLA),
the Parsortix microuidic system, ow cytometry, and the CellCelector
setup, DanioCTC eectively enriches and isolates CTCs from metasta-
sized breast cancer (MBC) patients for injection into zebrash embryos.
Validation experiments conrmed that MDA-MB-231 cells, transplanted
following the standard protocol, localized frequently to the head and
blood-forming regions of the zebrash host. Notably, when MDA-MB-231
cells spiked into DLA aliquots were processed using DanioCTC, cell dis-
semination patterns remained consistent. Successful xenograing of
CTCs from a MBC patient revealed their primary localization in the head
and trunk regions of zebrash embryos.
DanioCTC represents a major step forward in endeavors to study the dis-
semination of individual and rare patient-derived CTCs, thereby enhanc-
ing our understanding of metastatic breast cancer biology and facilitating
the development of targeted interventions in MBC.
Disclosure Statement: e authors declare no conict of interest.
904
The tight junction protein claudin 18.2 is markedly and
therapeutically relevant heterogeneously distributed
incarcinomas of the upper gastrointestinal tract
Alexander Quaas
Universitätsklinik Köln, Institut für Pathologie, Köln, Deutschland
Background: Claudin 18.2 protein is overexpressed in adenocarcinoma of
the upper GI-tract. Zolbetuximab is a therapeutic monoclonal antibody
against Claudin 18.2 for therapy of HER2/neu-negativeupper GI-tract
carcinomas. Immunohistochemical staining was established as a predictive
biomarker. Little is known about its expression in the real-world patient
populations and its heterogeneity within the tumor and their metastases.
Methods: Paran-embedded tumor material from 1,283 patients (822
esophageal adenocarcinomas (EAC) and 461 gastric adenocarcinomas
(GAC) was analyzed for claudin 18.2 expression status. e immunohis-
tochemical antibody clone 43-11A used in the Spotlight study was applied.
Single and multi-spot tissue microarrays (TMAs) and whole tumor blocks
from primary tumors and lymph node metastases were analyzed. Eight
virtual endoscopic biopsies were taken from digitized whole tumor blocks.
Result: 24.8% of EAC and 28,6% of GAC were positive for CLDN18.2.
When comparing the results of only one single core biopsy with the
whole tissue section, the sensitivity for CLDN18.2 was low (58.8%).
e sensitivity increased to a maximum of 76.5% with 6 and 8 biopsies.
Discordant expression between primary tumor and corresponding local
lymph node metastasis was observed in 18.5%.
Discussion: e extent of claudin 18.2 positive carcinomas is lower than
in the Spotlight study (38%). In almost every h case, dierent expres-
sion results between the primary tumor and lymph node metastases can be
expected. At least six endoscopically obtained biopsies is necessary to obtain
a realistic picture of the actual expression status of the tumor for claudin
18.2. Comparable results have also been published for Her2/neu and PD-L1.
Conclusion: Claudin 18.2 is a heterogeneously expressed biomarker. In
the case of negative claudin 18.2 results, it must be clear on what evidence
this result is based. If necessary, a re-biopsy of the tumor or a biopsy of
metastases should be considered.
Disclosure Statement: e authors declare the following: Consulting contract with
Astellas-Pharma.
917
The Clonal Relationship and the Clinical Value of EpCAM
High-Expressing and Low-Expressing Circulating Tumor Cells
in Metastatic Breast Cancer
André Franken1; Annika Krämer1; Alicia Sicking1; Meike Watolla1,
Mahdi Rivandi1; Liwen Yang1; Jens Warfsmann2; Bernhard Polzer2;
Thomas W. P. Friedl3; Franziska Meier-Stiegen1; Nikolas H. Stoecklein4;
Wolfgang Janni3; Sabine Riethdorf5; Klaus Pantel5; André Koch6,
Natalia Krawczyk1; Dieter Niederacher1; Tanja Fehm1; Hans Neubauer1
1Department of Obstetrics and Gynecology, University Hospital and Medical
Faculty of the Heinrich-Heine University Duesseldorf, Düsseldorf, Deutschland
2Division “Personalized Tumor Therapy, Fraunhofer Institute for Toxicology and
Experimental Medicine, Regensburg, Deutschland
3Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm,
Deutschland
4General, Visceral and Pediatric Surgery, University Hospital and Medical Faculty
of the Heinrich Heine University Duesseldorf, Düsseldorf, Deutschland
5Department of Tumor Biology, University Hospital Hamburg-Eppendorf,
Hamburg, Deutschland
6Department of Obstetrics and Gynecology, University of Tübingen, Tübingen,
Deutschland
Background: Circulating tumor cells (CTCs) are mainly enriched based
on the epithelial cell adhesion molecule (EpCAM). Although it was shown
that an EpCAM low-expressing CTC fraction is not captured by such
approaches, knowledge about its prognostic and predictive relevance and its
relation to the EpCAM positive CTC subpopulation is lacking. To close this
gap of knowledge we developed an immunomagnetic assay to enrich CTCs
EpCAM-independently enabling the comparison of EpCAM high express-
ing and EpCAM low expressing CTCs obtained from the same patient.
Methods: CTCs were enriched from blood samples of metastatic breast
cancer patients using antibodies targeting Trop-2 and CD-49f. eir
EpCAM expression was determined by uorescence microscopy and
EpCAM high expressing and low expressing CTCs were isolated as single
cells. eir genomic DNA was amplied and analyzed regarding chromo-
somal aberrations and predictive mutations. Additionally, we compared
enrichment of CTCs using this antibody mix with the EpCAM based
enrichment using the CellSearch system.
Result: e combined application of antibodies against Trop-2 and
CD-49f achieved a synergistic eect on the CTC yield. Patients with
EpCAM high-expressing CTCs had a worse overall and progression free
survival. EpCAM high- and low-expressing CTCs presented similar chro-
mosomal aberrations and mutations indicating a close evolutionary rela-
tionship. A sequential enrichment of CTCs from the EpCAM depleted
fraction yielded a population of CTCs not captured EpCAM dependently
but harboring predictive information.
Conclusion: Our data indicate that EpCAM low-expressing CTCs could be
used as a valuable tumor surrogate material – although they may be prognos-
tically less relevant than EpCAM high-expressing CTCs – and have partic-
ular benet if no CTCs are detected using EpCAM dependent technologies.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 227
Late-Breaking Abstracts
Best-of-Abstract-Vortrag
Breast Cancer
1075
Inavolisib or placebo in combination with palbociclib and
fulvestrant in patients with PIK3CA-mutated, hormone
receptor-positive, HER2-negative locally advanced or
metastatic breast cancer: Phase III INAVO120 primary analysis
Sherko Kümmel1; Komal Jhaveri2; Seock-Ah Im3; Cristina Saura4;
DejanJuric5; Sibylle Loibl6; Kevin Kalinsky7; Peter Schmid8; Sherene Loi9;
Eirini Thanopoulou10; Noopur Shakar11; Guiyuan Lei10; Thomas Stout11;
Katherine Hutchinson11; Jennifer Schutzman11; Chunyan Song11;
NicholasTurner12
1Kliniken Essen-Mitte, Evangelische Huyssens-Stiftung/Knappschaft GmbH
Essen, Deutschland
2Breast and Early Drug Development Service, Department of Medicine,
Memorial Sloan Kettering Cancer Center, New York, NY, and Weill Cornell
Medical College, New York, USA
3Seoul National University Hospital, Seoul National University College of
Medicine, Cancer Research Institute, Seoul National University, Seoul, Republic
of Korea
4Breast Cancer Unit, Medical Oncology Service, Vall d’Hebron University
Hospital, Barcelona, Spain
5Medicine-Hematology and Medical Oncology, Massachusetts General Hospital
Cancer Center, Boston, USA
6German Breast Group, Neu-Isenburg, Germany; Centre for Haematology and
Oncology Bethanien, Goethe University, Frankfurt, Germany
7Winship Cancer Institute at Emory University, Atlanta, USA
8Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary
University of London, London, United Kingdom
9Division of Cancer Research, Peter MacCallum Cancer Centre, Melbourne,
Australia, and The Sir Peter MacCallum Department of Medical Oncology,
University of Melbourne, Parkville, Australien
10Roche Products Limited. Welwyn Garden City, United Kingdom
11Genentech, Inc., South San Francisco, USA
12Centre for Molecular Oncology, Royal Marsden Hospital and Institute of Cancer
Research, London, United Kingdom
Background: More eective treatments for patients (pts) with endocrine-
resistant, PIK3CA-mutated, hormone receptor-positive, HER2-negative
breast cancer (HR+, HER2– BC) that prevent or overcome resistance are
needed. Inavolisib is a highly potent and selective inhibitor of the PI3K
catalytic subunit α isoform protein. Prior preclinical data suggested sub-
stantial synergy between PI3K and cyclin-dependent kinase 4/6 inhibition
plus endocrine therapy.
Methods: e Phase III, randomized, double-blind INAVO120 trial
(NCT03006172) recruited 325 pts with PIK3CA-mutated, HR+, HER2–
locally advanced/metastatic BC (LA/mBC) who relapsed during or within
12 months of adjuvant endocrine therapy completion, and who had no
prior therapy for advanced BC. Pts were randomized to inavolisib (inavo)
(9 mg qd on Days 1–28 of each cycle) or placebo (qd) in combination
with palbociclib (palbo) (125 mg qd on Days 1–21 of each cycle) and ful-
vestrant (fulv) (500 mg im on Cycle 1 Days 1 and 15, and on Day 1 of
each subsequent cycle). e primary endpoint was investigator-assessed
progression-free survival (INV-PFS).
Result: Aer 21.3 months median follow-up, median INV-PFS was
15.0months (95% CI = 11.3, 20.5) with inavo+palbo+fulv, and 7.3 months
(95% CI = 5.6, 9.3) with placebo+palbo+fulv (hazard ratio 0.43; 95% CI =
0.32, 0.59). OS showed a trend in favor of inavo (hazard ratio 0.64; 95%
CI = 0.43, 0.97; p = 0.0338), with follow-up ongoing. Rates of selected
Grade 3–4 AEs with inavo and placebo were: neutropenia at 80.2% and
78.4%; hyperglycemia at 5.6% and 0%; diarrhea at 3.7% and 0%; stomatitis
and mucosal inammation at 5.6% and 0%; and rash at 0% and 0%.
Discussion: Inavo + palbo + fulv demonstrated a statistically signicant
and clinically meaningful improvement in INV-PFS in this high-risk
population, and a favorable OS trend at the rst interim analysis. Inavo
+ palbo + fulv had a manageable safety prole and no new safety signal
was identied.
Conclusion: Inavo + palbo + fulv could represent a new standard of care
for pts with PIK3CA-mutated, HR+, HER2– LA/mBC.
Prev. presented at SABCS, Jhaveri et al
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
1085
Adjuvant abemaciclib plus endocrine therapy for HR+, HER2-,
high-risk early breast cancer: results from a preplanned
monarchE overall survival interim analysis, including 5-year
ecacy outcomes
Mattea Reinisch1; Nadia Harbeck2; Priya Rastogi3; Joyce O’shaughnessy4;
Frances Boyle5; Javier Cortes6, 7; Hope S. Rugo8; Erika Hamilton9; MatthewP.
Goetz10; Chiun-Sheng Huang11; Elżbieta Senkus12; AlexeyTrakin13; Patrick
Neven14; Jens Huober15; Wei Ran16; Valerie Andre16; Maria Munoz-
Fernandez16; Belen San Antonio16; Ashwin Shahir16; MiguelMartín17;
Stephen Johnston18
1Evang. Kliniken Essen-Mitte, Clinic for Gynecology / Breast Center, Essen,
Deutschland
2Breast Centre, Department of Gynecology and Obstetrics, Comprehensive
Cancer Centre München, LMU University Hospital, München, Deutschland
3UPMC Hillman Cancer Center and NSABP Foundation, Pittsburgh, PA, USA
4Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX, USA
54Sydney Medical School, University of Sydney, Sydney, NSW, Australien
65International Breast Cancer Center (IBCC), Quironsalud Group, Barcelona
7International Breast Cancer Center (IBCC), Quironsalud Group, Barcelona,
Spanien
8Department of Medicine, University of California San Francisco, Helen Diller
Family Comprehensive Cancer Center, San Francisco, CA, USA
9Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN, USA
10Mayo Clinic, Rochester, MN, USA
11Department of Surgery, National Taiwan University Hospital, National Taiwan
University College of Medicine, Taipei City, Taiwan
12Medical University of Gdańsk, Gdańsk, Polen
13N.N. Blokhin Russian Cancer Research Center, Moscow, Russische Föderation
14Multidisciplinary Breast Center, University Hospitals Leuven, Louvain, Belgien
15Breast Center, Kantonsspital St. Gallen, St. Gallen, Schweiz
16Eli Lilly and Company, Indianapolis, IN, USA
17Hospital General Universitario Gregorio Marañon, Universidad Complutense,
CIBERONC, GEICAM, Madrid, Spanien
18The Royal Marsden NHS Foundation Trust, London, United Kingdom
Background: Two years (yrs) of adjuvant abemaciclib combined with
endocrine therapy (ET) resulted in signicant improvement in invasive dis-
ease-free survival (IDFS) and distant relapse-free survival (DRFS) that per-
sisted beyond the 2-yr treatment (tx) period in patients (pts) with hormone
receptor positive, human epidermal growth factor receptor 2 negative,
node-positive, high-risk early breast cancer (EBC). Here, we report 5-yr
ecacy results from a prespecied overall survival (OS) interim analysis.
Methods: Pts were randomized (1:1) to receive ET for at least 5 yrs +/-
abemaciclib for 2 yrs (tx period). High-risk EBC was dened as either ≥4
positive axillary lymph nodes (ALN) or 1-3 ALN with Grade 3 disease
and/or tumor ≥5 cm (Cohort 1). A smaller group of pts were enrolled with
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts228
1-3+ ALN and central Ki67 ≥20% (Cohort 2). e intent-to-treat (ITT)
population consisted of Cohort 1 (5120 pts) and Cohort 2 (517 pts).
Results: In the ITT population, with a median follow-up of 54 months,
the benet of abemaciclib was sustained with a HR of 0.680 (95% CI:
0.599, 0.772) for IDFS and 0.675 (95% CI: 0.588, 0.774) for DRFS. is
persistence of abemaciclib benet translated to continued separation of
the KM curves resulting in a 5-yr absolute improvement in IDFS and
DRFS rates of 7.6% and 6.7%, respectively, compared with IDFS/DRFS
rates of 6.0%/5.3% at 4 yrs and 4.8%/4.1% at 3 yrs. Tx benet in Cohort 1
was consistent with ITT. No new safety signals were observed. ere con-
tinued to be fewer deaths in the abemaciclib plus ET arm compared to the
ET arm (208 vs 234; HR 0.903; p=0.284); signicance was not met.
Discussion: At the pivotal 5-yr mark for adjuvant EBC trials, abemaciclib
plus ET continued to reduce the risk of developing invasive and distant
disease recurrence well beyond the completion of tx.
Conclusions: e increasing absolute improvement at 5 yrs is consistent
with a carryover eect and further supports the use of abemaciclib in pts
with high-risk EBC. OS data are evolving in favor of abemaciclib arm, and
follow-up continues.
Disclosure Statement: e authors declare the following: Vortrags- oder
Beratungshonorare oder Reisekostenübernahmen erhalten: AstraZeneca, Daiichi
Sankyo, Gilead, Lilly, MSD, Novartis, Pzer, Roche, Seagen and Somatex.
Endocrine Tumors
1133
Randomized phase 3 study of selpercatinib versus
cabozantinib or vandetanib in advanced, kinase inhibitor-
naïve, ret-mutant medullary thyroid cancer
Julien Hadoux1; Rosella Elisei2; Marcia Brose3; Ana Ho4; Bruce Robinson5;
Ming Gao6; Barbara Jarzab7; Pavel Isaev8; Katerina Kopeckova9;
JonathanWadsley10; Dagmar Führer11; Bhumsuk Keam12; Eric Sherman13;
Makoto Tahara14; Mimi Hu15; Yan Lin16; Patricia Maeda16; Lori Wirth17;
Jaume Capdevila18
1Gustave Roussy, Villejuif, Frankreich
2Endocrine Unit, Department of Clinical and Experimental Medicine, University
of Pisa, Pisa, Italien
3Sidney Kimmel Medical College, Philadelphia, USA
4Instituto do Câncer do Estado de São Paulo, Sao Paulo, Brasilien
5School of Medicine, Western Sydney University, Campbelltown, Australien
6Tianjin Cancer Institute & Hospital, Tianjin, China, VR
7Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska
Curie National Research Institute of Oncology, Gliwice Branch, Polen
8Federal State Institution Medical Radiology Research Center, Obninsk,
Russische Föderation
9Department of Oncology, 2nd Faculty of Medicine of Charles University and
Motol University Hospital, Prague, Tschechische Republik
10Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation
Trust, Sheied, United Kingdom
11Department of Endocrinology Diabetology and Metabolism, Endocrine
Tumour Center at West German Cancer Center, University Hospital Essen,
University of Duisburg-Essen, Essen, Deutschland
12Seoul National University Hospital, Seoul, Republik Korea
13Department of Medical Oncology, Memorial Sloan Kettering Cancer Center,
New York, USA
14National Cancer Center Hospital East, Kashiwa, Japan
15University of Texas MD Anderson Cancer Center, Houston, USA
16Eli Lilly and Company Corporate Center, Indianapolis, USA
17Massachusetts General Hospital, Boston, USA
18Medical Oncology Department, Vall d’Hebron Institute of Oncology,
Universitat Autònoma de Barcelona, Barcelona, Spanien
Background: Selpercatinib is a highly selective and potent RET inhibitor
approved for advanced RET-mutant medullary thyroid carcinoma (MTC)
but has not been directly compared with approved multikinase inhibitors
(MKI).
Methods: LIBRETTO-531 (NCT04211337) is a randomized phase 3 study
comparing rst-line selpercatinib versus cabozantinib or vandetanib.
Eligible patients had kinase inhibitor-naïve progressive disease documented
in the 14 months prior to enrollment. e pre-planned interim ecacy anal-
ysis occurred aer 59 progression-free survival (PFS) events. e primary
endpoint was blinded independent central review (BICR)-assessed PFS.
Result: In total, 291 patients were randomized. At a median follow-up
of 12 months, median PFS by BICR was not reached with selpercatinib
remaining inestimable (95% CI: NE, NE) and was 16.8 months (95%
CI: 12.2, 25.1) with control (HR: 0.280, 95% CI: 0.165, 0.475; P<.0001); by
investigator assessment the HR was 0.187 (95% CI: 0.109, 0.321; P<.0001).
BICR overall response rate (ORR) was 69.4% (95% CI: 62.4, 75.8) with
selpercatinib compared to 38.8% (95% CI: 29.1, 49.2) with control (odds
ratio 3.7, 95% CI, 2.2, 6.3; P<0.0001). At a median follow-up of 15 months,
overall survival (OS) was better with selpercatinib (HR: 0.374, 95% CI:
0.147, 0.949). e most common treatment-emergent adverse events
observed with selpercatinib were hypertension, dry mouth, and diarrhea;
and with control, diarrhea, palmar-plantar erythrodysaesthesia syndrome,
and hypertension. In total, 38.9% of patients treated with selpercatinib
had a dose reduction (versus 77.3% in control) and 4.7% discontinued
treatment due to an adverse event (versus 26.8% in control).
Discussion: e study met the interim analysis criteria of ecacy. First-
line selpercatinib delivered markedly prolonged PFS, improved ORR, and
better OS compared with MKI.
Conclusion: is study highlights the importance of selectivity in target-
ing RET-mutant MTC. Selpercatinib should be considered the preferred
rst-line standard of care for patients with advanced RET-mutant MTC.
Disclosure Statement: e authors declare the following: Mitgliedscha in
Beratungsgremien, Forschungsunterstützungen, Drittmittel
Gastrointestinal Cancer: other than colorectal
1141
Treatment response prediction and tumor evolution captured
in patient-derived organoids – Towards true precision
medicine in pancreatic cancer
Thomas Seuerlein1; Johann Gout2; Yazid J. Resheq1; Jessica
Lindenmayer3; Julian Schwab4; Johann Kraus4; Elodie Roger2;
DhariniSrinivasan2; Julia Kühlwein5, 6; Mark Hänle1; Thomas J. Ettrich1;
Karin Danzer5, 6; Alica K. Beutel7; Lukas Perkhofer2, 8; Hans Armin Kestler4;
Alexander Kleger2, 3, 8
1Department of Internal Medicine I, Ulm University Hospital, Ulm, Deutschland
2Institute for Molecular Oncology and Stem Cell Biology, Ulm University
Hospital, Ulm, Deutschland
3Core Facility Organoids, Ulm University, Ulm, Deutschland
4Institute of Medical Systems Biology, Ulm University, Ulm, Deutschland
5German Center for Neurodegenerative Diseases (DZNE), Ulm University, Ulm,
Deutschland
6Department of Neurology, Ulm University Hospital, Ulm, Deutschland
7University of California Irvine, Irvine, USA
8Division of Interdisciplinary Pancreatology, Department of Internal Medicine I,
Ulm University Hospital, Ulm, Deutschland
Background: Pancreatic cancer (PC) is characterized by an aggressive
biology and high tumor heterogeneity causing considerable variations
in therapy response. Patient-derived organoids (PDOs) reect parental
tumor features and represent a powerful preclinical tool to predict drug
response and harness personalized treatment.
Methods: We have derived >100 PDO lines from treatment-naïve and
pretreated PC primary tumor and metastases with a reliable ecacy and
previously developed a pharmacotyping-guided prediction model to
prognosticate patient therapy response. Following up our initial feasibil-
ity trial, we validated the model accuracy in 43 PC patients. To decipher
molecular mechanisms driving PC chemoresistance, we conducted whole
exome sequencing (WES) on seven longitudinal patients and single-nu-
cleus RNA/ATAC multiomics on a unique longitudinal case study.
Results/Discussion: Automation and drug screening miniaturization
enhanced our process capacity, allowing to extend our drug panel and
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 229
reducing time before pharmacotyping. Our model allowed a successful
drug response prediction in naïve patients with an accuracy of 82.3%
for 1st and 2nd line regimens. Prediction power was lower in pretreated
patients with a precision of 58.3%. Analysis of longitudinal samples
revealed a CHEK2-mutated patient responding over time upon PARP
inhibitor maintenance therapy, in line with our prediction, further high-
lighting the method robustness. WES revealed lower mutational bur-
den, while tracking clonal evolution unmasked therapy-linked changes.
Integrative analysis identied transcriptomic and epigenetic dynamics in
a longitudinal patient with a FGFR2 fusion. FGFR2 constitutive activation
correlated with aberrant epigenetic trace and transcription programs of
downstream targets as PI3K-AKT, MAPK, and RAS family members and
of RNA polymerase II transcription machinery.
Conclusions: Overall, we report a robust and clinically-relevant pre-
clinical tool for drug response prediction, paving the way towards a
PDO-based true precision medicine in clinical routine.
Disclosure Statement: e authors declare no conict of interest.
1000
Pathological complete response (pCR) to durvalumab
plus 5-uorouracil, leucovorin, oxaliplatin and docetaxel
(FLOT) in resectable gastric and gastroesophageal junction
cancer (GC/GEJC): Interim results of the global, phase III
MATTERHORN study
Markus Möhler1; Yelena Janjigian2; Salah-Eddin Al-Batran3;
ZevWainberg4; Eric Van Cutsem5; Daniela Molena6; Kei Muro7;
WooJinHyung8; Lucjan Wyrwicz9; Do-Youn Oh10; Takeshi Omori11;
Marcelo Garrido12; Oliveira Sulene Cunha Sousa13; Moishe Liberman14;
Victor Castro Oliden15; Mehmet Bilici16; John F. Kurland17; Ioannis Xynos18;
Helen Mann18; Josep Tabernero19
1Research Center for Immunotherapy (FZI), Johannes Gutenberg-University
Clinic, Mainz, Deutschland
2Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center,
New York, USA
3Institute of Clinical Cancer Research, Krankenhaus Nordwest, University Cancer
Center, Frankfurt, Deutschland
4Department of Gastrointestinal Medical Oncology, David Geen School of
Medicine at UCLA, Los Angeles, USA
5Department of Gastroenterology / Digestive Oncology, University Hospitals
Leuven and KU Leuven, Leuven, Belgien
6Division of Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New
York, USA
7Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
8Department of Surgery, Yonsei University College of Medicine, Seoul, Republik
Korea
9Department of Oncology and Radiotherapy, Maria Sklodowska-Curie National
Research Institute of Oncology, Warsaw, Polen
10Division of Medical Oncology, Department of Internal Medicine, Seoul
National University Hospital; Cancer Research Institute, Seoul National
University College of Medicine, Seoul, Republik Korea
11Department of Gastroenterological Surgery, Osaka International Cancer
Institute, Osaka, Japan
12Hemato-Oncology Department, SAGA Clinical Trial Centre and Universidad
Mayor, Santiago, Chile
13Clinical Oncology, The Clinical Research Center, Northern Riograndense
League Against Cancer, Natal, Brasilien
14Division of Thoracic Surgery, Department of Surgery, Centre Hospitalier de
l’Université de Montréal, Centre de Recherche du CHUM, Montreal, Kanada
15Medicina Oncologica Department, National Institute of Neoplastic Diseases
(INEN), Lima, Peru
16Department of Medical Oncology, Atatürk University Faculty of Medicine,
Erzurum, Türkei
17Oncology R&D, Late-Stage Development, AstraZeneca, Gaithersburg, USA
18Oncology R&D, Late-Stage Development, AstraZeneca, Cambridge, United
Kingdom
19Medical Oncology Department, Vall d’Hebron Hospital Campus & Institute of
Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spanien
Background: e global, Phase 3, randomized, double-blind, pla-
cebo (P)-controlled MATTERHORN study (NCT04592913) assesses
perioperative durvalumab (D) with FLOT in participants (pts) with
resectable GC/GEJC. Results of a pre-planned interim analysis (IA) are
reported.
Methods: Pts with resectable (>T2 N0-3 M0/T0-4 N1-3 M0) GC/GEJC
were randomized 1:1 to D 1500 mg or P every 4 weeks (Q4W) on Day 1
plus FLOT Q2W on Days 1 and 15 for 4 cycles (2 doses of D or P and 4
doses of FLOT pre- and post-operative), followed by D 1500 mg or P on
Day 1 Q4W for 10 further cycles. IA was conducted aer all random-
ized pts underwent or were precluded from surgery. Superiority of pCR
rate (α=0.1% [2-sided]) by central review (Modied Ryan) was assessed.
Surgical and safety outcomes were also assessed.
Result: ere were 474 pts randomized to each treatment arm. Baseline
characteristics were balanced between arms; 19% of pts in each enrolled
in Asia. e majority of pts had GC (68%), cT3 (66%; cT4, 25%) and
cLN+ (70%). A statistically signicant improvement in pCR was observed
with addition of D to FLOT versus P (19% vs 7%; 12%; odds ratio [OR],
3.08; p<0.00001). Combined pCR/near-complete pathological response
(pnCR) rate was 27% with D vs 14% with P (13%; OR, 2.19; p<0.00001).
Surgery rate and R0 resection rate (in pts who underwent surgery) were
similar with D (87% and 86%, respectively) vs P (84% and 86%, respec-
tively). Downstaging favored D vs P (T0, 23% vs 11%; pN0, 52% vs 37%;
by central review) in pts who underwent surgery. Median D and P expo-
sure was similar. Adverse event rates were similar between arms.
Conclusion: e addition of D to perioperative FLOT therapy demon-
strated a clinically meaningful and statistically signicant improve-
ment in pCR in resectable GC/GEJC, with a tolerable safety prole. e
MATTERHORN study is ongoing for the primary endpoint of event-free
survival.
Indication of source: Previously presented at ESMO 2023, LBA73: same title as
above, Yelena.Y. Janjigian et al. - Reused with permission.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts230
Genitourinary Cancer including Prostate
Cancer
1057
Nivolumab (NIVO) + gemcitabine-cisplatin (GC) vs GC alone
for previously untreated unresectable or metastatic urothelial
carcinoma (mUC): results from the phase 3 CheckMate 901 trial
Jens Bedke1; Michiel S. van der Heijden2; Guru Sonpavde3;
ThomasPowles4; Andrea Necchi5; Mauricio Burotto6; Michael Schenker7;
Juan Pablo Sade8; Aristotelis Bamias9; Philippe Beuzeboc10;
JanOldenburg11; Yüksel Ürün12; Dingwei Ye13; Zhisong He14;
BegoñaP.Valderrama15; Yoshihiko Tomita16; Jeiry Filian17;
DanielaPurcea18; Federico Nasroulah17; Matthew Galsky19
1Department of Urology, Eberhard Karls University Tübingen, Tübingen,
Deutschland
2Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam,
Niederlande
3Medical Oncology, Genitourinary Section, Dana-Farber Cancer Institute,
Harvard Medical School, Boston, USA
4Department of Genitourinary Oncology, Barts Cancer Institute, Queen Mary
University of London, London, United Kingdom
5Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei
Tumori, Milan, Italien
6Department of Oncology, Bradford Hill Clinical Research Center, Santiago, Chile
7Department of Medical Oncology, Sf. Nectarie Oncology Center; Department
of Oncology, University of Medicine and Pharmacy, Craiova, Rumänien
8Department of Clinical Oncology, Alexander Fleming Institute, Buenos Aires,
Argentinien
9Second Propaedeutic Department of Medicine, National and Kapodistrian
University of Athens, ATTIKON University Hospital, Athens, Griechenland
10Department of Urologic Oncology, Hopital Foch, Suresnes, Frankreich
11Department of Oncology, Akershus University Hospital (Ahus), Lørenskog,
Norwegen
12Department of Medical Oncology, Ankara University, Ankara, Türkei
13Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai,
China, VR
14Department of Urology, Peking University First Hospital, Beijing, China, VR
15Department of Medical Oncology, Hospital Universitario Virgen del Rocío,
Sevilla, Spanien
16Department of Urology, Niigata University Graduate School of Medical and
Dental Sciences, Niigata, Japan
17Bristol Myers Squibb, Princeton, USA
18Bristol Myers Squibb, Boudry, Schweiz
19Department of Medicine, Tisch Cancer Institute, Icahn School of Medicine at
Mount Sinai, New York, USA
Background: Cisplatin (cis)-based chemotherapy (chemo) has been the
rst-line standard of care (SOC) for cis-eligible patients (pts) with mUC
for decades, and prior attempts to improve upon this treatment have been
unsuccessful. We report results for NIVO+GC or GC alone in CheckMate
901.
Methods: In CheckMate 901 (NCT03036098), a global, open-label, ran-
domized phase 3 trial, pts received NIVO 360 mg + GC Q3W for up
to 6 cycles followed by NIVO 480 mg Q4W until disease progression/
unacceptable toxicity or up to a maximum of 2 years, or GC Q3W for
up to 6 cycles. Stratication factors were PD-L1 status and liver metas-
tasis. Primary endpoints were overall survival (OS) and progression-free
survival (PFS) by blinded independent central review (BICR). Objective
response rate (ORR) per BICR was an exploratory endpoint.
Result: 304 pts were randomized to each arm. With a median follow-up
of 33.6 mo, both OS (HR, 0.78; 95% CI, 0.63–0.96; P = 0.0171) and PFS
(HR, 0.72; 95% CI, 0.59–0.88; P = 0.0012) were signicantly improved
with NIVO+GC vs GC. Median OS (95% CI) was 21.7 (18.6–26.4) vs 18.9
(14.7–22.4) mo for NIVO+GC vs GC, with OS probabilities of 70.2% vs
62.7% at 12 mo and 46.9% vs 40.7% at 24 mo; median PFS (95% CI) was
7.9 (7.6–9.5) vs 7.6 (6.1–7.8) mo, with PFS probabilities of 34.2% vs 21.8%
at 12 mo and 23.5% vs 9.6% at 24 mo. ORR and complete response (CR)
rates were 57.6% and 21.7% with NIVO+GC vs 43.1% and 11.8% with GC.
Median duration of CR (95% CI) was 37.1 (18.1–not estimable) mo for
NIVO+GC vs 13.2 (7.3–18.4) mo with GC. Grade ≥ 3 treatment-related
AEs occurred in 61.8% of pts in the NIVO+GC arm and 51.7% of pts in
the GC arm.
Discussion: NIVO+GC demonstrated statistically signicant and clin-
ically meaningful improvements in OS and PFS vs GC alone as rst-
line treatment for mUC with no new toxicity signals. NIVO+GC is the
rst frontline concurrent checkpoint inhibitor + chemo combination to
improve OS in this setting.
Conclusion: ese results support NIVO + cis-based chemo as a new
SOC for pts with mUC.
Previously presented at the ESMO Annual Meeting 2023, LBA7, van der Heijden
MS, et al. Reused with permission.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
Hematooncology including Bone marrow
transplantation, Lymphoma, Plasmocytoma
1054
Estimating the impact of radiotherapy in young,
high-risk patients with aggressive b-cell lymphoma:
along-term analysis of the open-label, randomized,
phase 3 R-MegaCHOEP trial
Michael Oertel1; Marita Ziepert2; Fabian Frontzek3; Nina Nacke1; Maike
Nickelsen4; Bertram Glaß5; Viola Poeschel6; Christian Rübe7; Georg Lenz3;
Norbert Schmitz3; Hans Theodor Eich1
1Klinik für Strahlentherapie - Radioonkologie - Universitätsklinikum Münster,
Münster, Deutschland
2Institut für Medizinische Informatik, Statistik und Epidemiologie - Universität
Leipzig, Leipzig, Deutschland
3Medizinischen Klinik A: Hämatologie, Hämostaseologie, Onkologie und
Pneumologie - Universitätsklinikum Münster, Münster, Deutschland
4Onkologie Lerchenfeld, Hamburg, Deutschland
5Hämatologie und Zelltherapie - Helios Klinikum Berlin-Buch, Berlin,
Deutschland
6Klinik für Innere Medizin I - Onkologie, Hämatol. Immun. & Rheumatololgie -
Universitätsklinikum des Saarlandes, Homburg, Deutschland
7Klinik für Strahlentherapie und Radioonkologie - Universitätsklinikum des
Saarlandes, Homburg, Deutschland
Background: e role of consolidative radiotherapy (RT) for patients
with aggressive B-cell lymphoma is to be dened. e R-MegaCHOEP
trial analyzed the use of high-dose chemotherapy and rituximab followed
by autologous stem cell transplantation compared to R-CHOEP immu-
nochemotherapy for patients up to 60 years1,2. e presented work ana-
lyzes the impact of RT regarding long-term ecacy and side-eects.
Methods: e analysis included 261 patients with a median follow-up of
112.4 months. Consolidative RT was indicated for extranodal involve-
ment or bulky disease (maximum diameter ≥ 7.5 cm). In addition, RT
could be administered because of insucient response at end of therapy.
Result: Overall, 120 patients underwent RT. Patients with RT had pre-
dominantly an age-adjusted IPI of 2 (75 %) and an elevated LDH (96.7
%). Bulky disease was present in 103/120 patients in the RT-arm and
was located mainly in the mediastinal (44) and paraaortal (17) regions.
Median RT dose was 36 Gray in median fractions of 1.8 Gray. Toxicities
were generally mild to moderate with only 24 and 8 grade 3 and 4 tox-
icities reported during RT. During long-term follow-up, 23 secondary
malignancies occurred, with RT being no signicant contributing risk
factor (p = 0.504). In the overall study population, patients with RT had
an improved event-free survival (EFS; 63.9 % vs. 46.0 %; p<0.001) and
progression-free survival (PFS; 67.2 % vs. 54.1 %; p = 0.025) but not over-
all survival (OS; p = 0.132) in comparison to non-irradiated patients aer
10 years. For patients with bulky disease, RT resulted in a signicantly
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 231
better outcome (10-year EFS: 64.4 % vs. 34.5 %; p<0.001; 10-year PFS:
68.3 % vs. 47.4 %; p = 0.003; 10-year OS: 71.5 % vs. 59.4 %; p = 0.011),
when compared to patients without RT.
Conclusion: RT improved outcome in young, high-risk patients with
aggressive B-cell lymphoma and bulky disease and should be discussed as
part of the rst line treatment for these patients.
Indication of source:
1 Lancet Oncol 2012;13(12):1250–1259.
2 Lancet Haematol 2021;8(4):e267–e277.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
Lung Cancer
1136
AI-driven, mIF-based cell-omics reveals spatially resolved cell
signature for outcome prediction in NSCLC patients.
Simon Schallenberg1; Gabriel Dernbach1,2; Sharon Ruane2; Cornelius
Böhm2; Lukas Ru2; Kai Standvoss2; Sandip Ghosh2; Marco Frentsch3;
Mihnea P. Dragomir1; Rebecca Fritz1; Ines Koch1; Corinna Friedrich1;
Il-Kang Na3; Sabine Merkelbach-Bruse4; Alexander Quaas4; Nikolaj Frost5;
Kyrill Boschung6; Winfried Randerath6; Georg Schlachtenberger7;
MatthiasHeldwein7; Ulrich Keilholz8; Khosro Hekmat7;
Jens-CarstenRückert9; Reinhard Büttner4; Angela Vasaturo10;
DavidHorst1; Maximilian Alber2; Frederick Klauschen1,11
1Institut für Pathologie der Charite, Berlin, Deutschland
2Aignostics GmbH, Berlin, Deutschland
3Institut für Hämatologie, Onkologie und Tumorimmunologie der Charite,
Berlin, Deutschland
4Institut für Pathologie, Uniklinikum Köln, Köln, Deutschland
5Institut für Infektiologie und Pneumologie der Charite, Berlin, Deutschland
6Bethanien Krankenhaus, Klinik für Pneumologie und Allergologie, Solingen,
Deutschland
7Institut für Thoraxchirurgie, Uniklinikum Köln, Köln, Deutschland
8Comprehensive Cancer Center der Charite, Berlin, Deutschland
9Institut für Thoraxchirurgie der Charite, Berlin, Deutschland
10Ultivue, Cambridge, USA
11Institut für Pathologie der Ludwig-Maximilians-Universität, München,
Deutschland
Background: Lung cancer is the leading cause of cancer death worldwide.
Non-small cell lung cancer (NSCLC) represents about 80% of all lung
cancer cases. e tumor microenvironment (TME) inuences the clinical
outcome, whereby the location and composition of immune cells relates to
their function and activity. erefore, we developed a multiplex immuno-
uorescence (miF)-based, AI-driven approach for spatially resolved TME
characterization at the cellular level and used this to successfully predict
patient survival.
Methods: We collected FFPE tissue and clinicopathological data from
1168 patients with resected NSCLC from Berlin and Cologne. Aer tis-
sue microarray construction, sections were stained with a 12-plex immu-
nouorescence (IF) panel and with hematoxylin, eosin, respectively, and
all stains were scanned and co-registered with single cell accuracy. An
H&E-based tissue segmentation model was trained to detect the dierent
tumor regions: carcinoma, stroma, and necrosis. Next, a nucleus-based
cell detection model, and 12 binary cell classication models were devel-
oped to classify each detected cell by their H&E and miF staining. At last,
we trained a model on the Berlin cohort using the spatially resolved cell
readouts of cell densities in regions, marker expression, cell neighborhood
niches, to predict patient survival on the Cologne cohort.
Result: Our prediction model identied spatially resolved cell signatures
to predict patient survival. e model signicantly improves over the
UICC8 baseline for LUSC (63.6 to 71.5 C-Score) and LUAD (64.5 to 68.9
C-Score) on the hold-out cohort.
Discussion: Our approach illustrates the utility of cell-based spatial anal-
yses and highlights how AI can improve our understanding of TME fea-
tures that underlie clinical outcome.
Conclusion: e combination of our large real-world clinical cohort,
multiplex panel, and automated AI approach enabled the detection of a
specic cell neighborhood signature to predict patient survival, outper-
forming the commonly used UICC8 staging system.
Disclosure Statement: e authors declare the following: Beratungstätigkeit bei der
Aignostics GmbH
965
Real-world data on the eectiveness of a nationwide precision
medicine program for advanced non-small cell lung cancer –
The national Network Genomic Medicine Lung Cancer
Anika Kästner1; Anna Kron2,3; Neeltje van den Berg1; Kilson Moon1;
Matthias Scheer2,3; Gerhard Schillinger4; Natalie Pelusi3,5;
NilsHartmann3,6; Damian Rieke3,7; Susann Stephan-Falkenau3,8;
MartinSchuler3,9; Martin Wermke3,10; Wilko Weichert3,11;
FrederickKlauschen3,12; Florian Haller3,13; Horst-Dieter Hummel3,14;
MartinSebastian3,15; Stefan Gattenlöhner3,16; Carsten Bokemeyer3,17;
IreneEsposito3,18; Florian Jakobs3,19; Christof von Kalle3,20;
ReinhardBüttner3,21; Jürgen Wolf2,3; Wolfgang Homann1
1Institute for Community Medicine, Section Epidemiology of Health Care and
Community Health, University Medicine Greifswald, Greifswald, Deutschland
2Department I of Internal Medicine, Center for Integrated Oncology Aachen
Bonn Cologne Duesseldorf, Lung Cancer Group Cologne, University Hospital of
Cologne, Köln, Deutschland
3National Network Genomic Medicine Lung Cancer, Köln, Deutschland
4AOK Bundesverband, Berlin, Deutschland
5Institute of Pathology, University Hospital Bonn, Bonn, Deutschland
6Institute of Pathology, University Medical Center, Johannes Gutenberg
University Mainz, Mainz, Deutschland
7Charité Comprehensive Cancer Center, Charité Universitätsmedizin Berlin,
Berlin, Deutschland
8Institute of Pathology, Helios Klinikum Emil von Behring, Berlin, Deutschland
9West German Cancer Center, University Hospital Essen, Essen, Deutschland
10Clinic for Internal Medicine I, University Hospital Carl Gustav Carus and
Medical Faculty of the TU Dresden, Dresden, Deutschland
11Institute of Pathology, Technical University of Munich (TUM), München,
Deutschland
12Institute of Pathology, Ludwig-Maximilians-University (LMU), München,
Deutschland
13Institute of Pathology, Friedrich-Alexander University Erlangen-Nuremberg,
University Hospital Erlangen, Erlangen, Deutschland
14Translational Oncology/Early Clinical Trial Unit (ECTU), Comprehensive Cancer
Center Mainfranken and Bavarian Cancer Research Center (BZKF), University
Hospital Würzburg, Würzburg, Deutschland
15Department of Medicine II, Hematology/Oncology, University Hospital
Frankfurt, Frankfurt, Deutschland
16Department of Pathology, University Hospital Giessen and Marburg, Giessen,
Deutschland
17University Cancer Center Hamburg, University Medical Center Hamburg-
Eppendorf, Hamburg, Deutschland
18Institute of Pathology, Heinrich-Heine-University and University Hospital
Duesseldorf, Düsseldorf, Deutschland
19Department of Hematology and Stem Cell Transplantation, Faculty of
Medicine and University Hospital Essen, University of Duisburg-Essen, Essen,
Deutschland
20Berlin Institute of Health at Charité Universitätsmedizin Berlin, Berlin,
Deutschland
21Institute of Pathology, Faculty of Medicine and University Hospital Cologne,
Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Lung
Cancer Group Cologne, University of Cologne, Köln, Deutschland
Background: Despite guideline recommendations, up to 10% of patients
with advanced non-small cell lung cancer (aNSCLC) in Germany still do not
receive any molecular diagnostics. e German national Network Genomic
Medicine Lung Cancer (nNGM) provides comprehensive molecular diag-
nostics and personalized treatment information for patients with aNSCLC.
e primary aim of this study was to determine whether participation in the
precision medicine program (PMP) nNGM improves overall survival (OS).
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts232
Methods: Patients with initial diagnosis of aNSCLC between April 2019
and June 2020 and insurance coverage by AOK (German health insur-
ance) were included in this historical cohort analysis. e nNGM-group
comprised patients who received molecular diagnostics and personalized
treatment information within the nNGM, while the non-nNGM-group
received usual care. Claims data (in- and outpatient AOK data) were pro-
vided for both groups and, for the nNGM-group, were case-specically
merged with electronic health record data from the nNGM.
Result: n=509 patients were included in the nNGM-group and n=7,
213patients in the non-nNGM-group. e OS of the nNGM-group was
signicantly higher compared to the non-nNGM-group (10.5 months vs.
8.7 months, p=0.008, HR=0.84, 95%CI: 0.74-0.95). e 1-year OS rates
were 46.8% in the nNGM-group and 41.3% in the non-nNGM-group.
Patients in the nNGM-group received more frequently rst-line targeted
therapies compared to the non-nNGM-group (nNGM: 8.4%; non-nNGM:
5.1%; p=0.001).
Discussion: As personalized treatment strategies for aNSCLC continue
to advance, oncologists face clinical, nancial, and administrative chal-
lenges. A structured and standardized PMP has the potential to enhance
the implementation of precision medicine in routine care.
Conclusion: We found improved OS and increased use of targeted ther-
apies in aNSCLC patients participating in the nNGM, indicating that a
PMP can facilitate translation of the latest scientic knowledge into rou-
tine care, leading to improved clinical outcomes.
Disclosure Statement: e authors declare no conict of interest.
Poster
Articial Intelligence in Cancer Care and
Diagnostics
1074
Spatial proling of the SCLC tumor microenvironment
dened by high MHC-I expression reveals association with
functionally relevant antigen presentation
Miljenka Vuko1,2; Felix Segerer1,2; Xie Mingchao1;
MonicaAzquetaGavaldon1,2; Andreas Spitzmüller1,2; Harald Hessel1,2;
Marco Testori1,2; Michael Surace1; Mari Heininen-Brown1;
ShashankSaran1; Helen Angell1; Jamie Rodriguez Canales1;
GünterSchmidt1,2; Nicolas Brieu1,2; Hadassah Sade1,2; Carl Barrett1;
Christian Eisen1,2; Markus Schick1,2; Giulia Fabbri1
1AstraZeneca Early Oncology, Oncology R&D, Gaithersburg, USA
2AstraZeneca Computational Pathology, Early Oncology R&D, München,
Deutschland
Background: Small cell lung cancer (SCLC) is an aggressive and largely
immune-cold cancer type, for which chemotherapy combined with
Immuno-oncology (IO) therapies is providing benet only in a subgroup
of patients. One of the established subtypes is characterized by an inamed
immune gene signature and high expression of MHC class I (MHC-I).
Here, we aimed to assess the spatial characteristics of immune cells in the
SCLC “inamed” subtype characterized by high expression of MHC class
I (MHC-I) investigating its role as a potential biomarker.
Methods: We combined a computational pathology approach with mul-
tiplex immunouorescence (mIF) to prole the SCLC tumor microenvi-
ronment. To this end, 126 SCLC FFPE tissue samples were stained with
two mIF panels consisting of six markers each: (A) PanCK, CD8, CD68,
PD-1, PD-L1, and Ki67; (B) CD20, NKp46, CD1c, CD66b, ICOS, and
FOXP3. Based on this, we investigated the location and phenotype of each
cell within the tumor center, the stroma and tumor epithelium.
Result: We observed higher densities of CD8+ cytotoxic, FOXP3+ reg-
ulatory, and ICOS+ T-cells in the tumor center of MHC-I high cases.
Considering the role of MHC-I in antigen presentation and T-cell acti-
vation, we investigated the proportion of CD8;PD-1;Ki67+ T-cells out of
all CD8+ cells and found the proportion to be signicantly higher in the
parenchyma of MHC-I high cases. is eect was not observed in cases
with MHC-I H-score of less than 30.
Discussion: e high proportion of triple-positive CD8+ T-cells present
in the tumor parenchyma and absent in the stroma of MHC-I high cases,
indicate an association with functionally relevant presentation of tumor
antigens by MHC-I on SCLC tumor cells.
Conclusion: We utilized computational pathology to comprehensively
prole the composition and spatial arrangement of the TME in inamed
SCLC cases dened by high MHC-I expression. Our ndings provide the
functional rationale for MHC-I as a biomarker for a potentially increased
response to IO therapies.
Disclosure Statement: e authors declare the following: Active or Previous
employees of AstraZeneca and may own stock or stock options.
1079
Discovery of predictive biomarkers for precision immuno-
oncology using computational pathology-based digital twins
Günter Schmidt1; Jan Lesniak1; Thomas Kunzke1; Federico Pollastri1;
Markus Schick1; Johannes Zimmermann1; Ross Stewart2
1AstraZeneca Computational Pathology GmbH, Early Oncology R&D, München,
Deutschland
2AstraZeneca Oncology R&D, Oncology Translational Medicine, Cambridge,
United Kingdom
Purpose: Exploratory data from single-arm PhI/II clinical trials provide
a unique opportunity for predictive biomarker discovery, however, the
absence of a control arm poses a signicant risk to subsequent signicant
biomarker-driven PhIII trials.
Methods: A Digital Twin is the computational description a real patient
based on their clinical data, including digitized whole slide images (WSI) of
histopathology baseline samples. Here, we demonstrate the generation of a
virtual randomized PhIII clinical trial (vPhIII) via Digital Twins and their
application for predictive biomarker discovery in Non Small Cell Lung
Cancer (NSCLC). To this end, WSI of NSCLC tissue samples from a PhI/
II trial (NCT01693562) and the PhIII trial MYSTIC (NCT02453282)were
digitally analyzed with quantitative continuous scoring of PD-L1 protein
expression (PD-L1 QCS). For each PhI/II patient, its Digital Twin was
generated by identifying the most similar matching patient in the PhIII
control arm based on their image features.
Result: Screening PD-L1 QCS features for their longest median OS time
(mOS) benet in the QCS-positive vPhIII sub-group, the feature provid-
ing longest mOS benet was evaluated in the real PhIII cohort. In total,
N=121 Digital Twins were generated as vPhIII cohort, while average mOS
benet analysis for each feature indicated that the 20% quantile of PD-L1
tumor cell expression provided optimal stratication.
Discussion: e mOS comparison of the real PhIII with the vPhIII
showed the OS benet from ICI treatment has been underestimated by
the Digital Twins model. Although the selected QCS feature did not indi-
cate signicant treatment benet in the vPhIII, a retrospective analysis of
MYSTIC hints towards benecial patient stratication.
Conclusion: Digital Twins based on imaging data are a promising approach
to generate virtual randomized and biomarker stratied PhIII trials based
on single-arm PhI/II and historic Standard-of-Care data. is proof-of-con-
cept study demonstrates technical feasibility of this innovative methodology.
Disclosure Statement: e authors declare the following: Active or Previous
employees of AstraZeneca and may own stock or stock op-tions.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 233
1140
Multiphase modeling and patient-specic simulation of
tumors in soft tissue
Marlon Suditsch1; Tim Ricken1; Arndt Wagner2
1Institut für Statik und Dynamik der Luft- und Raumfahrtkonstruktionen,
Universität Stuttgart Campus Vaihingen, Stuttgart, Deutschland
2Insitut für Mechanik (Bauwesen), Universität Stuttgart Campus Vaihingen,
Stuttgart, Deutschland
Background: In critical tissue areas such as in the brain, additional
chemo- and radiation therapy is essential in conjunction with resection of
a tumor or is the only possible form of a therapy at all. In this regard, the
decision on a suitable form of therapy is extremely challenging. e aim
of the presented work is to develop a simulation tool called OncoFEM that
supports clinicians in this decision-making process by combining data-
and knowledge-driven approaches and predicting a tumor evolution from
inputs of imaging techniques such as magnetic resonance imaging.
Methods: Relevant information of the microstructural composition of
the healthy tissue and the position of the tumor are identied with dif-
ferent machine learning tools, such as convolutional neural networks.
Prepared referential states are simulated with the relevant processes by
embedding a continuum-mechanical, multi-phasic model in the frame-
work of the eory of Porous Media, cf. Wagner [1]. Based on Wolf et al.
[2], the tumor is divided into its necrotic and active solid core, which is
enclosed by an edema in the surrounding tissue, that consists of an extra-
cellular matrix and interstitial uid. e latter includes additive compo-
nents, e.g. glucose, growth factors or an applied therapeutic agent
Results and Discussion: In addition to the basic eects of diusive
spreading and the mass eect, actual situations from the tumors emer-
gence growing up to the pre-operative state, its resection and the applica-
tion of a drug can be simulated with a well parametrized model.
Conclusion: By consideration of multiple solids and uid-resolved
additive components, relevant clinical questions can be studied from
multi-scientic perspectives.
Indication of source:
1 A. Wagner. Continuum mechanics of multicomponent materials: modelling,
numerics and applications for biological materials in the framework of the
theory of porous media. Habilitation. University of Stuttgart (2021)
2 K. J. Wolf et al.. Dissecting and rebuilding the glioblastoma microenvironment
with engineered materials. Nature Reviews Materials (2019) 10: 615-668
Disclosure Statement: e authors declare no conict of interest.
Biomarker
1073
Optimizing Genomic Analyses in Challenging FFPE Samples
Nicolas Casadei1; Michaela Pogoda1; Florian Harmuth1; Jakob Admard1;
Alexander Ott1; Tobias Haack1; Stephan Ossowski1; Sorin Armeanu-
Ebinger1; Christopher Schroeder1; Olaf Riess1
1Institute for Medical Genetics and Applied Genomics, Tübingen, Deutschland
Background: Advances in genomics, particularly through methods such
as whole genome sequencing and whole exome sequencing, have funda-
mentally changed the study of somatic mutations that are essential for
understanding tumor biology and adjusting therapeutic interventions in
the eld of personalized medicine.
Methods: Although formalin-xed paran-embedded tissue is com-
monly used as the primary source of tumor material for histological anal-
ysis, analyzing genomic nucleic acids extracted from such samples poses
signicant challenges including fragmented molecules, chemical modi-
cations and high levels of cross-linking to proteins. At the same time,
advances in genomic library preparation aim to simplify procedures and
reduce costs by combining multiple enzymatic steps into a single reaction,
but this unication presents an additional challenge in maintaining rigor-
ous quality for low-quality DNA and RNA.
Result: Our study addresses these diculties by ne-tuning RNA and
DNA sequencing protocols and introducing strategic adaptations to
improve library preparation yields and reduce artefacts. Specically, we
describe adjustments made to an RNA sequencing protocol using ribo-
somal depletion, a whole genome protocol with library amplication, and
an exome enrichment protocol to enhance the sequencing outcomes.
Discussion: e study provides detailed insights and a valuable frame-
work for troubleshooting suboptimal protocols in genomics laboratories
working with low-quality DNA and RNA
Conclusion: By outlining the critical steps for monitoring and improve-
ment, our ndings aim to strengthen the robustness of genomic analyses
in challenging sample contexts.
Disclosure Statement: e authors declare no conict of interest.
Breast Cancer
1053
Phase III study of adjuvant ado-trastuzumab emtansine vs
trastuzumab for residual invasive HER2-positive early breast
cancer after neoadjuvant chemotherapy and HER2-targeted
therapy: KATHERINE nal IDFS and updated OS analysis
Michael Untch1; Sibylle Loibl2; Max S. Mano3; Chiun-Sheng Huang4;
Eleftherios P. Mamounas5; Norman Wolmark6; Adam Knott7;
AsnaSiddiqui7; Thomas Boulet8; Beatrice Nyawira8; Eleonora Restuccia8;
Charles E. Geyer6
1AGO-B and Helios Klinikum Berlin Buch, Berlin, Deutschland
2German Breast Group, Neu-Isenburg, Germany, Centre for Haematology and
Oncology Bethanien, Goethe University, Frankfurt, Germany
3Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
4National Taiwan University Hospital and National Taiwan University College of
Medicine, Taipei, Taiwan
5NSABP Foundation, Pittsburgh, PA and Orlando Health Cancer Institute,
Orlando, FL, USA
6NSABP Foundation and University of Pittsburgh/UPMC Hillman Cancer Center,
Pittsburgh, PA, USA
7Roche Products Limited, Welwyn Garden City, UK
8F. Homann-La Roche Ltd, Basel, Switzerland
Background: Patients with HER2-positive early breast cancer (EBC) who
have residual invasive disease aer neoadjuvant chemotherapy [NACT]
+ HER2-targeted therapy have a high risk of recurrence and death. e
standard of care when KATHERINE was designed was continuation of the
same HER2-targeted therapy in the adjuvant setting.
Methods: KATHERINE (NCT01772472) is a phase III, open-label, global
study of patients with centrally conrmed, HER2-positive (IHC 3+ or in
situ hybridization-positive) primary BC (T1–4, N0–3, M0) who received
NACT + HER2-targeted therapy, which had to include a taxane and tras-
tuzumab, followed by surgery, with residual invasive disease in the breast
and/or axillary lymph nodes. Within 12 weeks of surgery, patients were
randomized 1:1 to T-DM1 (3.6 mg/kg intravenously [IV] every 3 weeks
[q3w]) or trastuzumab (6 mg/kg IV q3w) for 14 cycles.
Result: With a median follow-up of 8.4 years (101 months), T-DM1 sus-
tained the improvement in IDFS compared to trastuzumab (hazard ratio
[HR] 0.54; 95% condence interval [CI] = 0.44, 0.66; p < 0.0001). 7-year
IDFS rates were increased from 67.1% with trastuzumab to 80.8% with
T-DM1; a dierence of 13.7%. At clinical cuto for the nal IDFS analysis,
215 deaths had been reported. T-DM1 signicantly reduced the relative
risk of death by 34% compared with trastuzumab (HR 0.66; 95% CI = 0.51,
0.87; p = 0.0027). 7-year OS rates were increased from 84.4% with trastu-
zumab to 89.1% with T-DM1; a dierence of 4.7%. OS and IDFS benets
were seen across key subgroups. A low incidence of adverse events (AEs)
was observed during the post-treatment period.
Discussion: T-DM1 signicantly improved OS in patients with HER2-
positive EBC with residual invasive disease aer neoadjuvant therapy. e
IDFS benet of T-DM1 was sustained in the intention-to-treat population
with longer follow-up, and no new safety issues emerged.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts234
Conclusion: T-DM1 is the rst therapy to show improved survival
post-surgery in patients with HER2-positive EBC with residual invasive
disease aer neoadjuvant therapy.
Prev. presented at SABCS, Loibl et. al
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
1058
Blood test instead of mammography? Validation of
CpGmarkers on precursor lesions and early breast cancer
resections
Sandra Krüger1; Hans-Michael Behrens1; Fritz K.W. Schäfer2;
ChristophRöcken1
1Department of Pathology, UKSH Campus Kiel, Kiel, Deutschland
2Department of Gynecology and Obstetrics, UKSH Campus Kiel, Kiel,
Deutschland
Background: Although the introduction of mammography made a sig-
nicant contribution to breast cancer (BC) screening, it comes with
severe limitations. Only 50% of eligible women make use of this screening
method as they might fear radiation, it lacks sensitivity for patients with
dense breast tissue, and it disregards patients younger than 50, which make
up to 25% of BC cases[1]. To reach more patients with a widely applicable
screening method, we investigated if four CpG markers known to reliably
detect advanced BC[2] can distinguish B3 lesions from early malignancies.
Methods: Pyro sequencing and droplet digital PCR assays were devel-
oped to screen 248 formalin-xed and paran-embedded (FFPE) early
BCs, 89 ductal carcinomas in situ (DCIS) and 49 B3 lesions. Furthermore,
promoter CpG sites of the aected four genes were examined and their
protein products were analyzed using immunohistochemistry.
Result: ree out of four CpG markers could signicantly distinguish B3
lesions from early malignancies. Additional CpG sites were identied,
whose methylation dierentiated benign from malignant. Furthermore,
both promoter and intragenic methylation could be linked to protein
expression, thereby identifying new therapeutic targets.
Discussion: Our PCR-based assays conrmed that CpG markers are able
to detect advanced BC and above that, to detect early stage cancer includ-
ing DCIS. However, the data collected on articially modied FFPE DNA
of tumor resections must be validated on cell-free DNA in further studies,
to provide a screening tool applicable for blood samples.
Conclusion: CpG markers have great potential for BC screening and
PCR-based assays present a cost-eective method for this purpose. In
addition, methylome and corresponding protein analyses can identify
further therapy and prognostic targets.
Indication of source:
1 Kramp, L-J et al. 2021 DOI: 10.1007/s00432-021-03841-x
2 Zhang et al., 2021 DOI: 10.1038/s41523-021-00316-7
Disclosure Statement: e authors declare no conict of interest.
1095
Genome Sequencing oers innovative answers for current
issues like personnel shortage, increasing healthcare costs
and diagnostics gap in HBOC
Dennis Witt1; Ulrike Faust1; Kristin Bosse1; Cristiana Roggia1; Janna Witt1;
Silja Gauss1; Antje Stäbler1; Marc Sturm2; German Demidov2;
TobiasHaack1; Stephan Ossowski2; Olaf Riess1; Christopher Schroeder1
1Institut für Medizinische Genetik und Angewandte Genomik,
Universitätsklinikum Tübingen, Tübingen, Deutschland
2NGS Competence Center Tübingen, Universitätsklinikum Tübingen, Tübingen,
Deutschland
Background: Hereditary Breast and Ovarian Cancer (HBOC) syndrome
is a frequent cancer predisposition and substantially increases cancer
risks in aected patients. Genetic testing typically targets 10-19 risk genes
and causative variants are identied in less than 20% of cases. Due to this
diagnostic gap new sequencing techniques, like genome sequencing (GS),
promise identication of new genetic markers for predictive testing and
clinical management.
Methods: e study involved 819 breast or ovarian cancer patients with
suspected HBOC familial history and 4810 healthy control patients.GS
was conducted in our accredited lab following standard procedures.
Results: GS produced >899 million reads, with an average depth of 41.16x.
Coverage of risk genes signicantly outperformed exome sequencing
(99.34% vs. 95.63%, p<0.001). GS achieved over 99% sensitivity and PPV for
SNVs, and over 95% for SVs. GS reduced MLPA testing by approximately
93% and allowed a higher annual sample throughput (373 vs. 322 samples).
Causative variants were found in 12.7% of cases across 9 HBOC genes.
Simultaneous detection of polygenic risk scores (using PRS313) suggested a
potential explanation for additional breast cancer cases. e in-depth char-
acterization of two complex structural variants aecting BARD1 and ATM
conrmed the advantages of GS over conventional testing methods.
Discussion: Current HBOC genetic testing, combining various methods,
is streamlined by GS, enhancing diagnostic yield by identifying additional
structural variants. PRS313 might explain up to an additional 20% of
cases. GS signicantly improves diagnostic capabilities for larger patient
cohorts. In conclusion, GS allows to eciently extend the diagnostic
capacity for larger patient cohorts.
Disclosure Statement: e authors declare no conict of interest.
Cancer of Unknown Primary (CUP)
995
Primary analysis of ecacy and safety in the CUPISCO trial:
A randomised, global study of targeted therapy or cancer
immunotherapy guided by comprehensive genomic proling
(CGP) vs platinum-based chemotherapy (CTX) in newly
diagnosed, unfavourable cancer of unknown primary (CUP)
Alwin Krämer1; Linda Mileshkin2; Tilmann Bochtler3; Chantal Pauli4;
Gonzalo Durán-Pacheco5; Cagatay Arslan6; Frédéric Bigot7;
NasséraChalabi5; Natalie Cook8; Antoine Italiano9; Ferran Losa10;
JulianaJanoski de Menezes11; Chantal Michaud5; Mustafa Özgüroğlu12;
Roberto A. Pazo-Cid13; Jerey S. Ross14; Kai-Keen Shiu15; Michael Stahl16;
Marlene Thomas5; Holger Moch4
1German Cancer Research Center (DKFZ) and University of Heidelberg,
Heidelberg, Germany
2Peter MacCallum Cancer Centre and University of Melbourne, Melbourne,
Australia
3German Cancer Research Center (DKFZ), University of Heidelberg and National
Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
4University of Zürich and University Hospital Zürich, Zürich, Switzerland
5F. Homann-La Roche Ltd, Basel, Switzerland
6Medical Park İzmir Hospital, İzmir, Turkey
7Institut de Cancérologie de l’Ouest, Nantes-Angers, France
8The University of Manchester and the Christie NHS Foundation Trust,
Manchester, UK
9Institut Bergonié, Bordeaux, France
10Hospital de Sant Joan Despí Moisès Broggi, ICO Hospitalet, Barcelona, Spain
11Centro Pesquisa Integrado em Oncologia, Porto Alegre, Brazil
12Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
13Miguel Servet University Hospital, Zaragoza, Spain
14Foundation Medicine, Inc./ SUNY Upstate Medical University, Cambridge/
Syracuse, USA
15UCL Cancer Institute, London, UK
16Evang. Kliniken Essen-Mitte, Essen, Germany
Purpose: With platinum-based CTX, prognosis of patients (pts) with
unfavorable CUP is poor; however, CGP may inform treatment strate-
gies based on cancer genomics. e CUPISCO trial (NCT03498521)
compared the ecacy and safety of molecularly guided therapy (MGT) vs
standard platinum-based CTX in pts with newly diagnosed, unfavorable,
non-squamous CUP.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 235
Methods: Pts had central eligibility review-conrmed CUP with ≥1 mea-
surable lesion (investigator-assessed via RECIST v1.1). All had tumor
tissue and/or blood CGP (Foundation Medicine, Inc.). Aer 3 induction
CTX cycles, pts with disease control were randomized 3:1 to MGT (inves-
tigator’s choice from 12 regimens aer molecular tumor board advice) or
continuation of CTX, stratied by gender and response to induction CTX.
e primary endpoint was progression-free survival (PFS). Secondary
endpoints included overall survival (OS), objective response rate (ORR),
duration of response (DoR) and disease control rate (DCR). Safety was
also assessed. Exploratory endpoints included quality of life (QoL).
Result: From Jul 2018–Dec 2022, 436 pts were randomized: 326 to MGT;
110 to CTX. Median PFS (intent-to-treat population) was 6.1 months
(95% condence interval [CI] 4.7–6.5) with MGT vs 4.4 months (4.1–5.6)
with CTX (hazard ratio [HR] 0.72; 95% CI 0.56–0.92; P=0.0079). Median
OS was 14.7 (95% CI 13.3–17.3) vs 11.0 months (9.7–15.4), respectively
(HR 0.82; 95% CI 0.62–1.09; P=0.1779), though OS data were immature at
cuto. ORR was 9.6% (95% CI 2.4–16.8, P=0.0141) in favor of MGT, with
similar DoR in each arm (HR 0.95; 95% CI 0.33–2.72). DCR was 4.7%
(95% CI –6.4–15.9; P=0.3922) in favor of MGT. Adverse event rates were
generally similar with MGT vs CTX; no dierence in QoL was observed.
Discussion: In pts with newly diagnosed, unfavorable, non-squamous
CUP who responded to induction CTX, CGP with MGT improved PFS
compared to CTX continuation.
Conclusion: Early CGP and MGT should be considered the new standard
of care for these pts.
Previously presented at ESMO, LBA16, Linda Mileshkin et al. - Reused with
permission
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
Central Nervous System
1143
Real world experience with TTFields in glioma patients with
emphasis on therapy usage
Claudius Jelgersma1; Joan Alsolivany1; Gülsüm Akkas1; David Wasilewski1;
Bastian Gastl2; Martin Misch1; David Kaul3; Lars Bullinger4; Peter Vajkoczy1;
Julia Sophie Onken1
1Charité - Universitätsmedizin Neurochirurgie, Berlin, Deutschland
2Novocure GmbH, München, Deutschland
3Charité - Universitätsmedizin Radioonkologie und Strahlentherapie, Berlin,
Deutschland
4Charité - Universitätsmedizin Hämatologie, Onkologie und Tumorimmunologie,
Berlin, Deutschland
Background: Tumor Treating Fields (TTF) therapy, an adjunctive treat-
ment for high-grade tumors, gained prominence following the 2017 EF-14
trial. It enhances outcomes in progression-free survival (PFS) and overall
survival (OS) when used over 18 hours daily (75% usage). EF-14’s post-
hoc analysis shows over 90% usage oers additional benets, whereas it
showed no eect at all below 50% usage. Given the cost-intensive nature
and signicant constraints associated with the therapy, our objective is to
generate real-world data on therapy usage through a retrospective analysis
at a high-throughput academic center.
Methods: From June 2015 to February 2022, 113 patients with high-grade
glioma received TTFields, with 8 discontinuing within 2 months and
excluded from further analysis.
Result: e average age of patients was 49.6 years; 75.2% began therapy
with their rst-line treatment, including 27.6% who started TTFields
simultaneously with the initial temozolomide cycle. 15.2% started TTFields
in the 2nd-line and 9.5% in the 3rd-line setting. e average therapy dura-
tion was 9.3 months, with a 65.5% mean usage. Usage peaked in the rst
3 cycles (77.7%, 72.3%, and 71.6%), then gradually declined over time.
Linear regression found no predictors of usage. Upon recurrence, 55% of
patients continued TTFields treatment. However, the patients exhibit a
signicant drop in usage rates to averaging 52.3%. Interestingly, no eect
on usage rate was observed before the diagnosis of a tumor recurrence was
communicated.
Conclusion: is study reveals that actual usage falls below the recom-
mended 75%, underscoring the need for adherence monitoring and
strategies to improve long-term commitment to TTFields in managing
high-grade gliomas.
Disclosure Statement: e authors declare the following: Drittmittel Novocure,
Reisekostenunterstützung
1103
Senescence is the main trait induced by temozolomide in
glioblastoma cells
Lea Beltzig1; Christian Schwarzenbach1; Petra Leukel2; Clemens Sommer2;
Alessandro Tancredi3; Monika Hegi3; Markus Christmann1; Bernd Kaina1
1Universitätsmedizin, Institut für Toxikologie, Mainz, Deutschland
2Universitätsmedizin, Institut für Neuropathologie, Mainz, Deutschland
3Neuroscience Research Center and Neurosurgery, Lausanne University
Hospital, Epalinges, Schweiz
Background: Gold standard in the treatment of glioblastoma (GBM) is
radio-chemotherapy, using the alkylating agent temozolomide (TMZ).
TMZ methylates the tumor cell DNA giving rise to N-alkylations and
O6-methylguanine (O6MeG). While the N-alkylated DNA bases are
removed from DNA by base excision repair (BER), O6MeG is repaired
by MGMT, which is lacking in about 40% of glioblastomas (GBM). If not
repaired, O6MeG results in secondary DNA damage that trigger the DNA
damage response (DDR). is leads to activation of the apoptotic and also
the autophagy and cellular senescence (CSEN) pathway. Here we charac-
terized the CSEN pathway induced by TMZ in more detail.
Methods: Apoptosis and CSEN were measured by ow cytometry; CSEN
in specimens were detected by immunohistochemistry.
Result: Analysis of long-term (10d) TMZ treated cells show nearly 90%
of senescent cells, a high level of trimethylated H3K9 and H3K27, high
amounts of DSBs outside of telomers and a sustained activation of the
DDR by upregulation of the p53-p21 axis. TMZ-induced GBM cells exhibit
the senescence-associated secretory phenotype (SASP): they secreted
proinammatory cytokines such as interleukin-1 (IL-1), IL-6 and IL-8.
Senescent cells were also found in GBM specimens, that displayed higher
levels of CSEN in recurrences compared to the primary tumour. To further
elucidate the role of O6MeG in senescence induction following TMZ treat-
ment, we used a tet-on system to induce MGMT following TMZ treatment.
Upregulation of MGMT 1-2d aer TMZ treatment completely abrogated
CSEN induction, while MGMT upregulation >3d following TMZ treat-
ment had no eect. Induction of MGMT in senescent cells did not reduce
the senescence level.
Discussion: ese results revealed that senescence is the main response
of TMZ-treated GBM cells and indicate that senescence is a key pathway
triggered by adjuvant radio-chemotherapy of GBM.
Conclusion: ese results indicate, that O6MeG is absolutely essential for
the induction, but not maintenance of the senescence state.
Disclosure Statement: e authors declare no conict of interest.
1034
Analysis of the immune microenvironment of chordoma
tumors
Zhenlin Wang1; Andreas Unterberg1; Christel Herold-Mende1; Rolf Warta1
1The Department of Neurosurgery, University Hospital Heidelberg, Heidelberg,
Deutschland
Background: Chordoma is highly recurrent due to the poor en-bloc resec-
tion rate and low sensitivity to conventional chemotherapy and radiother-
apy. e objective of the study is to explore potential markers for prognosis
and immunotherapy of chordoma.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts236
Methods: 53 chordoma patients who underwent resection surgery at
the Department of Neurosurgery, University Hospital Heidelberg were
included. Cryopreserved samples were utilized for immunouorescence
(IF) staining of tumor-associated macrophage (TAM-general: CD68+,
M2-like TAM: CD68+/CD163+), tumor-inltrating T lymphocyte (TIL-
general: CD3+, cytotoxic T cell: CD3+/CD8+, regulatory T cell: CD3+/
CD8-/FoxP3+), and tumor cells (pan-cytokeratin+). e localization and
quantity of cells have been assessed using the semi-automated analysis
soware, StrataQuest.
Result: 53 samples were analyzed including 25 primary tumors (25%),
28 males (56%), 37 clivus-located tumors (70%), 15 so-tissue inltrating
tumors (28%), and 34 receiving postoperative radiotherapy (64%). e
median age was 40 years (range: 2-77) with a median progression-free
survival (PFS) of 14 months (range: 0-176). e IF staining revealed a sig-
nicant presence of inltrating immune cells with median percentages of
3.67% TAMs (0.34-25.55%), 2.29% M2-like TAMs (0.13-11.03%), 6.28%
TILs (1.34-31.29%), 1.26% cytotoxic T cells (0.18-8.35%), and 0.16% reg-
ulatory T cells (0.04-0.85%). Furthermore, a higher inltration level of
TAM or cytotoxic T cell was associated with a better PFS. Moreover, a
higher intratumoral TAM inltration was signicantly associated with an
increased OS in the group of newly diagnosed chordomas.
Discussion: As in the majority of other tumor entities, high TAM inl-
tration is associated with unfavorable outcomes, our results may indicate
novel mechanisms in chordoma and require more in-depth analysis.
Conclusion: e association of high TAM inltration and prolonged PFS
indicates that chordoma patients might benet from immune-activating
therapies.
Disclosure Statement: e authors declare no conict of interest.
Endocrine Tumors
1020
Safety and ecacy of everolimus (EVE) as second–line
treatment in neuroendocrine neoplasms G3 (NEN G3) - an AIO
phase II study (EVINEC)
Marianne Pavel1; Günter Klöppel2; Ludwig Fischer von Weikersthal3;
DieterHörsch4; Karin Mayer5; Jörg Schrader6; Marinela Augustin7;
MarinoVenerito8; Katrin Krause9; Leonidas Apostolidis10
1Universitätsklinik Erlangen, Gastroenterology and Hepatology, Endocrinology
Dept, Erlangen, Deutschland
2Technical University Munich, Institute of Pathology, München, Deutschland
3Klinikum St. Marien Amberg, Onkologisches Zentrum, Amberg, Deutschland
4Zentralklinik Bad Berka, Department of Internal Medicine/Gastroenterology
and Endocrinology, Bad Berka, Deutschland
5Universitätsklinikum Bonn, Department of Haematology and Oncology, Bonn,
Deutschland
6Universitätsklinikum Hamburg Eppendorf, Center of Internal Medicine,
Hamburg, Deutschland
7Klinikum Nürnberg, Clinic for Internal Medicine, Centre for Oncology/
Haematology, Nürnberg, Deutschland
8Universitätsklinik Magdeburg, Department of Gastrointestinal Oncology,
Magdeburg, Deutschland
9AIO-Studien-gGmbH, Project Management Sponsor, Berlin, Deutschland
10National Center for Tumor Diseases (NCT) Heidelberg, Department of Medical
Oncology, Heidelberg, Deutschland
Background: Well-di neuroendocrine tumors G3 (NET G3) represent a
separate entity from poorly di neuroendocrine carcinoma (NEC). While
platinum-based 1st line CTx is established in adv NEC, there is limited
ecacy of 2nd line CTx, therapy of NET G3 is still under investigation.
Since the mTOR inhibitor EVE mediates disease stabilization in pts with
NET G1/G2, and data on targeted therapy in NEN G3 were lacking, we
investigated EVE as 2nd line trt in NEN G3.
Methods: EVINEC was a prospective, single-arm, phase 2 study planned
to enroll 40 pts with hist conf NET G3/NEC G3 with progressive disease
on/aer platinum-based CTx. Trt was EVE 10 mg/day. Prim endpoint was
safety. Central review was performed by a highly experienced pathologist.
Result: 39 pts were initially found eligible. For 3 of these, central review
determined their tumors not to be NEN. Of the remaining 36, 13 were
NET G3, 14 NEC, and 9 mixed neuroendocrine-nonneuroendocrine neo-
plasms (MiNEN). MiNEN pts remained on study since NEN components
were NEC G3.
Most frequent EVE-related AEs were stomatitis (39%), fatigue (31%),
diarrhea (28%), nausea (25%), decr appetite (22%), epistaxis (19%), rash
(19%), decr weight (17%), back pain (14%), dry mouth (14%), aphthous
ulcer (11%), dermatitis acneiform (11%), and pyrexia (11%). 2 pts (6%)
were aected by pneumonitis, and trt-related infections were reported for
5 pts (14%).
Median PFS and OS for the Per Protocol (PP) population were 2.2 and
12.0mo, in NET G3 5.2 (range 0.7-18.8) and 23.9 mo, in NEC 1.8 and 5.6mo,
and in MiNEN 2.2 and 7.0 mo, respectively. 6 pts were excluded from the
PP set due to short trt duration or lack of ecacy assessment.
Conclusion: No clinically relevant safety signals for EVE aer prior plat-
inum-based therapy in NEN G3 were identied. e data support e-
cacy in NET G3 but insucient activity in NEC or MANEC. More data
are warranted from prospective trials in NET G3 to address EVE ecacy
compared to other trts.
Study sponsored by AIO-Studien-gGmbH, supported by a grant from Novartis.
Previously presented at ESMO Congress 2023, Abstract 1708, Marianne Pavel et al
Disclosure Statement: e authors declare no conict of interest.
Epidemiology
984
Prevalence of polycythemia vera, cytoreductive treatment,
and thromboembolic events in aected patients: a study
based on longitudinal German health claims data
Karina Manz1; Anja Mocek1; Bashar Morouj2; Katharina Merker3;
MarcFeuerbach3; Ariane Höer1; Valeria Weber1; Raeleesha Norris2;
Susanne Großer3; Frank Andersohn4; Haifa Al-Ali5
1IGES Institut GmbH, Berlin, Deutschland
2InGef – Institut für angewandte Gesundheitsforschung Berlin GmbH, Berlin,
Deutschland
3Novartis Pharma GmbH, Nürnberg, Deutschland
4Frank Andersohn Consulting & Research Services, Berlin, Deutschland
5Universitätsklinikum Halle, Halle (Saale), Deutschland
Background: Data on prevalence and treatment of polycythemia vera (PV)
in Germany are scarce. Guidelines recommend cytoreductive therapy for
high-risk PV (biologic age ≥60 years or history of thromboembolic event
[TE]). Second-line therapy is indicated in case of intolerance/resistance
(IT/R) to rst-line therapy.
Methods: We performed an observational study based on anonymized
claims data from the InGef database (years 2016-2021). Patients with
prevalent PV were identied using dened diagnosis, therapy, and physi-
cian specialty codes. Patients aged ≥60 years or with TE in the respective
year or in the previous 2 years were considered high-risk. We assessed the
share of patients with prescriptions for cytoreductive drugs. Using dened
diagnosis and therapy codes, we identied patients treated with hydroxy-
urea (HU) “only” (= no ruxolitinib [RUX]) and signs of IT/R. We ana-
lyzed the occurrence of TEs over a period of 1 to 3 years among prevalent
patients on continuous treatment (Tx) with HU and signs of IT/R (= HU
cohorts) and those on continuous RUX-Tx (= RUX cohorts).
Results: Extrapolated to the adult German population, the prevalence of
PV for 2021 was 28.6/100,000. 83.2 % of patients were high-risk. 46.3 %
of these patients received no cytoreductive Tx, 41.2 % HU only (of which
63.2 % showed signs of IT/R), and 13.8 % RUX. e RUX cohorts tended
to be younger and healthier than the HU cohorts. TEs were more common
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 237
in the HU cohorts (45.7 % had ≥1 TE within 1 year, 56.3 % had ≥1 TE
within 3 years) than in the RUX cohorts (29.1 % and 35.8 %, respectively).
Discussion: A large share of patients treated with HU show signs of IT/R.
Almost 50 % of high-risk patients received no cytoreductive Tx. In prac-
tice, it appears that younger and healthier patients are more likely to be
switched from HU to RUX. TEs seem to be more common in patients on
continuous Tx with HU only and signs of IT/R.
Conclusion: Our study provides recent insights into the prevalence and
the Tx situation of PV in Germany. Our results suggest that adherence to
Tx guidelines for high-risk PV is suboptimal. is may lead to otherwise
preventable TEs.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed. e study was funded by Novarits Pharma GmbH.
Gastrointestinal Cancer: Colorectal
1015
“Early-onset” colorectal cancer: Perioperative outcome and
analysis of patients’ demographics in a surgical cohort of the
DGAV StuDoQ database
Ulrich Wirth1; Josene Schardey1; Sezal Panchal2; Carsten Klinger2;
Christoph-Thomas Germer3; Dimitrios Pantelis4; Nico Schäfer5;
ChristophReißfelder6; Bernard W. Renz1; Joachim Andrassy1; Jens Werner1;
Florian Kühn1
1LMU Klinikum, München, Deutschland
2DGAV, Berlin, Deutschland
3Universitätsklinikum Würzburg, Würzburg, Deutschland
4Universitätsklinikum Bonn, Bonn, Deutschland
5Klinikum Leverkusen, Leverkusen, Deutschland
6Universitätsklinikum Mannheim, Mannheim, Deutschland
Background: ere has been a signicant increase in the incidence of
colorectal cancer (CRC) in patients under the age of 50, which is also
referred to as “early-onset” CRC (EO-CRC). Our aim was to compare
tumor-related and perioperative data between patients with EO-CRC and
average-onset” CRC (> 50 years; AO-CRC) in a large cohort of surgical
patients.
Methods: e StuDoQ database of the DGAV for colorectal cancer sur-
gery with a total of 66,712 documented cases from 2013 to 2022 was avail-
able. 4,137 cases were excluded due to incomplete data. e remaining
62,575 cases were analyzed comparatively according to tumor-related
and perioperative data between EO-CRC (4,101) vs. AO-CRC (58,474)
groups.
Result: e mean age in the groups was 43.58 ± 6.4 and 71.77 ± 10.1 years.
Tumor location was signicantly dierently distributed with a higher
pro-portion of rectal and le-sided cancer (χ2: p<0.001) in the EO-CRC
group. e number of neoplastic lymph nodes was signicantly higher in
the EO-CRC group (p<0.001). Patients with EO-CRC were signicantly
more likely to have metastases at the time of surgery than patients with
AO-CRC (χ2: p<0.001). In the EO-CRC group, MSI examination (χ2:
p<0.001) and genetic counseling were signicantly more frequent (29.2%
vs. 3.5%; χ2: p<0.001). As expected, family history was signicantly more
oen positive in the EO-CRC group (χ2: p<0.001). Complications such as
post-operative bleeding (χ2: p=0.01), postoperative ileus (χ2: p=0.29) and
wound infections (χ2: p<0.001) occurred less frequently in the EO-CRC
group. However, anastomotic leakage occurred signicantly more fre-
quently in the EO-CRC group (χ2: p<0.001).
Discussion: ere are clear dierences in terms of tumor-related data
between the EO-CRC and AO-CRC groups. Furthermore, there are sig-
nicant dierences in terms of perioperative complication rates.
Conclusion: ere are relevant dierences between patients with EO-CRC
and AO-CRC, which should be taken into account in daily patient care.
Disclosure Statement: e authors declare no conict of interest.
1055
Real world data of early-onset colon cancer (EO-CC) from the
AIO Colopredict Plus (CPP) Registry: Clinical and molecular
characteristics, treatment and outcome
Ira Ekmekciu1; Doreen-Maria Gisder2; Iris Tischo2; Jens Christmann2;
InkeFeder2; Elena Schlageter1; Sarah Wisser2; Celine Lugnier1; Anna-
LenaKraeft1; Robin Denz3; Heiner Wolters4; Vera Heuer5; Bülent Sargin6;
Stephan Hollerbach7; Christof Lamberti8; Andrea Tannapfel2;
AnkeReinacher-Schick1
1Department of Hematology, Oncology and Palliative Care, St. Josef-Hospital
Bochum, Ruhr-University Bochum, Bochum, Deutschland
2Institute of Pathology, Georgius Agricola Stiftung Ruhr, Ruhr-University
Bochum, Bochum, Deutschland
3Department of Medical Informatics, Biometry and Epidemiology, Ruhr-
University Bochum, Bochum, Deutschland
4Department of Visceral and General Surgery, St. Josef-Hospital Dortmund,
Dortmund, Deutschland
5Department of Oncology, St. Anna Hospital Herne, Herne, Deutschland
6Hematology and Internal Oncology, St. Marien Hospital Lünen, Lünen,
Deutschland
7Department of Medicine and Gastroenterology, Allgemeines Krankenhaus
Celle, Celle, Deutschland
8Hematology and Oncology, Klinikum Coburg, Coburg, Deutschland
Background: e incidence of EO-CC (age <50 years (yrs)) is rising with
limited data on its clinical and molecular characteristics. We analyzed a
real world cohort of the AIO CPP Registry.
Methods: CPP collects data and tissue from patients (pts) with CC UICC
stage I-III. Clinical and molecular characteristics were assessed compar-
ing pts <50yrs with pts 50+ using students t Test and Fishers exact test.
Disease-free (DFS) and overall survival (OS) rate at 3 and 5 yrs were
reported. Median follow-up was 28.1 months.
Results: Out of 9399 pts 479 (5%) had EO-CC (median age 44 yrs (22-49)
vs. 72 yrs (50-100) in late-onset (LO-)CC. ere were no signicant dier-
ences regarding sex or BMI. Younger pts had less comorbidities (Charlson
comorbidity Index, CCI 0: 91%) than older pts. (CCI 0: 60%, p <0.001).
Interestingly, younger patients had larger tumors (p=0.045), more oen
lymph node metastases (p=0.002) and thus higher UICC stages (p<0,001).
Tumor localization was predominantly le-sided in EO- (53%) and right-
sided in LO-CC (61%, p<0,001). Younger pts more oen received adjuvant
chemotherapy and oxaliplatin combinations (p<0,001). Mutational anal-
ysis was available in 5048 pts. No signicant dierence in K- or N-RAS
mutations or MSI were detected. e KRAS subtype p.G12C and BRAF
mutations were signicantly less prevalent in EO- compared to LO-CC
(p=0,03 and p<0,01). Younger pts had a better 3 yrs DFS and 5yrs OS rate.
Discussion: Pts with EO-CC in our unique real world cohort have more
oen le primary tumors with more advanced stages, and yet better DFS/
OS. is may be due to fewer comorbidities and more intense chemother-
apy regmiens, but also distinct mechanisms of tumor biology may play a
role. Notably, existing prognostic data until now have yielded conicting
results. EO-CC pts display distinct molecular features which should be
considered when making treatment decisions.
Conclusion: Further research is imperative to gain a deeper understand-
ing of the distinctive characteristics within this demographic. Real-world
data can play a crucial role in addressing this question.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts238
Gastrointestinal Cancer: other than colorectal
1076
Single-cell proling unleashes KRAS-driven redrafting of the
tumor microenvironment before cancer onset
Chantal Allgöwer1; James Nagai2; Meike Hohwieler1; Ivan Costa2;
Alexander Kleger1
1Institute of Molecular Oncology and Stem Cell Biology, University Hospital Ulm,
Ulm, Deutschland
2Institute for Computational Genomics, RWTH Aachen University, Aachen,
Deutschland
Background: Pancreatic cancer is a highly lethal disease, commonly char-
acterized by aggressiveness and a unique microenvironment, with mutant
KRAS signaling being a pathophysiological hallmark event.
Methods: In order to gain a better understanding of KRAS-dependent sig-
naling, stem cell-derived pancreatic ductal-like organoids (PDLOs) were
induced by oncogenic KRAS expression followed by single cell RNA- and
bulk ATAC-sequencing. Furthermore, in silico approaches were used to
reconstruct a virtual pancreatic cancer space to unleash the KRAS driven
pathways mediating CAF reprogramming and T cell shielding preceding
cancer onset.
Result: is unique precancer state model allowed a comprehensive char-
acterization of early oncogenic events at cellular resolution. Specically,
mutated KRAS separated two ductal subpopulations with distinct gene
expression signatures, including overexpression of genes related to cell
motility and migration as well as enhanced cytokine-related signaling.
Various co-culture systems showed that KRASG12D-expressing PDLOs
are capable of inducing cancer-associated broblast (CAF) dierentiation
while also shielding KRAS-activated yet non-cancerous organoids from
Tcell inltration in vitro.
Disclosure Statement: e authors declare no conict of interest.
1123
Proton Therapy for Unresectable and Medically Inoperable
Locally Advanced Pancreatic Cancer
Ahmed Gawish1; Fabian Eberle1; Hilke Vorwerk1; Sebastian Adeberg1
1Universitätsklinikum Gießen und Marburg, Marburg, Deutschland
Background: is research investigates the side eects, survival rates,
and disease control outcomes of LAPC patients treated with PBT in our
facility.
Methods: A cohort of 44 patients diagnosed with inoperable LAPC at our
center were treated using PBT with a curative approach. A majority of the
patients underwent either prior or simultaneous chemotherapy. Kaplan-
Meier analysis measured overall survival, locoregional recurrence-free
survival, time to locoregional recurrence, distant metastasis-free survival,
and time to subsequent progression or metastasis.
Result: e median radiation dose administered was 54 Gy over 30 ses-
sions (range: 50.4-59.4 Gy over 19-33 sessions). e side eects were
manageable. Four severe (grade III and IV) adverse events (bone mar-
row dysfunction, gastrointestinal disturbances, stent displacement,
heart attack) were noted during or immediately post-radiotherapy; two
were attributed to the combination of chemo and radiation therapy.e
median overall survival post-diagnosis was 15 months (ranging from
3-41 months), while post-PBT it was 8 months (3-33 months). Median
locoregional recurrence-free survival post-PBT stood at 7.3 months
(2-27 months), with distant metastasis-free survival at 5.6 months (4-28
months). e rates for remaining free from locoregional recurrence at 6,
12, and 24 months were 86%, 70%, and 60%, respectively. All patients n-
ished the treatment without interruptions.
Discussion: ese results align with the recognized benets of proton
therapy. However, the ndings’ generalizability is restricted due to the
limited number of participants.
Conclusion: For LAPC, PBT showcased high tolerability and achieved
disease control and survival outcomes comparable to intensied pho-
ton-based radiation therapy.
Disclosure Statement: e authors declare no conict of interest.
1138
A comprehensive multiomics approach unravels druggable
tumor–stroma interactions in ATM-decient pancreatic cancer
Elodie Roger1; Eleni Zimmer1; Dharini Srinivasan1; Anna Härle1;
ArielAsuzano1; Michael Melzer1; Hannah Mummey2; Yun Lee2;
KyleJ.Gaulton2; Lukas Perkhofer1; Johann Gout1; Alexander Kleger1
1Institute for Molecular Oncology and Stem Cell Biology, Ulm University
Hospital, Ulm, Deutschland
2Department of Pediatrics, UC San Diego, La Jolla, USA
Background: e complex biology of pancreatic ductal adenocarcinoma
(PDAC) remains a signicant challenge and limits overcoming its dismal
prognosis. Dynamic interactions within the tumor microenvironment
(TME) play a crucial role in PDAC pathogenesis. Uncharted eld lies in
the impact of gene mutations within the tumor epithelium on driving dis-
tinct oncogenic TME patterns. Our investigation into homologous recom-
bination deciency (HRD) caused by ATM inactivation, revealed its role
in promoting PDAC aggressiveness and desmoplastic reaction, suggesting
a unique TME programing.
Methods: Single-nucleus multiomics on ATM and/or P53-depleted
mouse PDACs, transcriptomics, secretomics, proteomics, and validation
in human cases, unveiled epigenetic, transcriptional, translational, and
secretory regulatory events, shedding light on the intricate dialog between
tumor cells and TME.
Results/Discussion: Multiomics integrative analysis and histological val-
idation in human PDACs showed ATM loss-specic myCAF enrichment
and reduced neutrophil and macrophage contents. Cell–cell communica-
tion inference revealed an ATM loss-specic tumor–CAF dialog driven
by TGFb signaling but distinct communication patterns between CAFs
and immune cells. Mechanistically, we validated a greater TGFβ release
by ATM-decient cells and revealed a reactive oxygen species (ROS)-
mediated phenomenon impacting tumor cell behavior and interplay
with CAFs. Combinatorial therapy targeting the TGFb-driven tumor
stroma dialog reversed cancer-promoting TME remodeling and boosted
FOLFIRINOX cytotoxicity in vivo, exclusively in ATM-decient PDACs.
Conclusions: Our study unveils the role of ATM-decient HRD tumor
cells in orchestrating oncogenic communication networks with CAFs
and immune cells. Our ndings paint a comprehensive picture of how
distinct tumor–stroma interactions reshape the TME, steering it towards
a cancer-promoting outcome and shed light on the potential to exploit
genotype-specic vulnerabilities via tailored tumor–stroma interference
strategies.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 239
Genitourinary Cancer including Prostate
Cancer
986
Metastases-directed therapy delays PSA-progression in oligo-
progressive castration resistant prostate cancer - early results
of a randomized clinical trial
Tobias Hölscher1,2; Fabian Lohaus1,2; Steen Löck1,2; Angelika Borkowetz3;
Christian Thomas3; Jörg Kotzerke4; Mechthild Krause1,2;
EstherG.C.Troost1,2
1Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and
University Hospital Carl Gustav Carus, Dresden, Deutschland
2OncoRay – National Center for Radiation Research in Oncology -, Faculty of
Medicine and University Hospital Carl Gustav Carus, Technische Universität
Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Deutschland
3Department of Urology, Faculty of Medicine and University Hospital Carl
Gustav Carus, Dresden, Deutschland
4Department of Nuclear Medicine, Faculty of Medicine and University Hospital
Carl Gustav Carus, Dresden, Deutschland
Purpose: e value of metastases-directed therapy (MDT) on outcome in
oligometastatic castration resistant prostate cancer (omCRPC) is unclear.
e randomized OLI-CR-P trial (NCT04141709) assesses MDT without
change of androgen deprivation therapy (ADT) in PSMA-PET-CT staged
patients (pts). We report on a planned interim analysis aer inclusion of
the rst 30 pts.
Methods: Between 12-2019 and 07-2023, pts with rising PSA and castrate
levels of testosterone during ADT or ADT + new androgen receptor path-
way inhibitor (ARPI) aer curative primary therapy and up to 5 PSMA-
positive bone- or lymph node metastases were eligible and randomized
2:1 in MDT and continuation of ADT (Arm 1) or continuation of ADT
alone (Arm 2). MDT was given as local ablative radiotherapy (3 x 10 Gy
or 25 x 2 Gy), at physicians’ discretion. e primary endpoint is the pro-
portion of pts without PSA progression (dened as nadir +2 ng/ml) aer
1 year. e OLI-CR-P study will enroll 66 patients and evaluate if MDT
results in less PSA progression compared to no MDT. At this interim anal-
ysis, the study would be stopped with a negative result if the dierence in
the primary endpoint between the two arms was less than 10%, and with
a positive result if the dierence between the two arms was highly statis-
tically signicant (p<0.001). e Ethics Committee of the TU Dresden
approved the protocol.
Results: 18 pts were allocated to Arm 1, 12 to Arm 2. e median pt age
was 71 years. Pts had undergone primary treatment at median 59 months
(mo) ago and were on ADT for at median 34 mo, and 8 used ARPI. All
but 1 in Arm1 (n=18) had MDT. Lymph node or bone metastases were
present in 11 and 14 pts, respectively, and 5 pts had both. Aer a median
follow-up of 21.3 mo, the median time to PSA-progression was 21.1 in
Arm 1 vs 6.5 mo in Arm 2 (p=0.05).
Discussion: In the pre-planned interim analysis, the addition of MDT
extended the time to PSA progression. However, as the pre-specied stop-
ping criteria for the OLI-CR-P interim analysis were not met, enrollment
will continue.
Conclusions: MDT in omCRPC seems promising, even without modi-
cation of systemic treatment.
Disclosure Statement: e authors declare no conict of interest.
1124
Nectin-4 and Trop-2: new therapeutic targets in penile cancer?
Jan Mink1; Markus Eckstein2; Oybek Khalmurzaev3; Alexey Pryalukhin4;
Carol Geppert2; Stefan Lohse5; Kristof Bende2; João Lobo6; Rui Henrique6;
Hagen Loertzer7; Joachim Steens8; Carmen Jerónimo6;
HeikoWunderlich9; Julia Heinzelbecker1; Rainer Bohle4; Michael Stöckle1;
Vsevolod Matveev3; Arndt Hartmann2; Kerstin Junker1
1Universitätsklinikum des Saarlandes, Abteilung für Urologie und
Kinderurologie, Homburg, Deutschland
2Universitätsklinikum Erlangen-Nürnberg, Institut für Pathologie, Erlangen,
Deutschland
3N.N. Blokhin National Medical Research Center of Oncology des
Gesundheitsministeriums der Russischen Föderation, Abteilung für Urologie,
Moskau, Russische Föderation
4Universitätsklinikum des Saarlandes, Abteilung für Pathologie, Homburg,
Deutschland
5Universitätsklinikum des Saarlandes, Abteilung für Virologie, Homburg,
Deutschland
6Portuguese Oncology Institute of Porto / Porto Comprehensive Cancer Center
Raquel Seruca, Department of Pathology and Cancer Biology and Epigenetics
Group – Research Center & School of Medicine and Biomedical Sciences
(ICBAS), University of Porto, Porto, Portugal
7Westpfalz-Klinikum, Abteilung für Urologie und Kinderurologie, Kaiserslautern,
Deutschland
8St.-Antonius-Hospital, Abteilung für Urologie und Kinderurologie, Eschweiler,
Deutschland
9St. Georg Klinikum, Abteilung für Urologie und Kinderurologie, Eisenach,
Deutschland
Background: While eective systemic therapies for penile cancer (PC) are
still missing, antibody-drug conjugates (ADC) as sacituzumab govitecan
(SG) and enfortumab vedotin (EV), ADCs against Trop-2 and Nectin-4,
showed high response rates in various tumor entities. erefore we inves-
tigated the expression of Trop-2 and Nectin-4 in PC as possible therapeu-
tic targets.
Methods: Clinical data and tissue samples from 203 patients with PC
from Germany, Russia and Portugal were collected. TNM, histological
subtype, grading and HPV-status were evaluated. Tissue micro arrays
from the primary tumor and lymph node metastases were constructed.
Nectin-4 and Trop-2 expression were analyzed using immunohistochem-
istry and classied by H-score (0-14 = negative; 15-99 = weak; 100-300 =
moderate/high).
Result: Moderate or high membranous Nectin-4 expression was found
in in 28.0% of the primary tumor samples and in 18.8% of metastases.
Expression in the primary tumor decreased signicantly with increasing
T-stage (p = <0.001) and did not correlate with HPV status (p = 0.788). It
was also not associated with metastasis-free (p = 0.758), cancer-specic (p
= 0.261) or overall survival (p = 0.345). Median H-score of Trop-2 was 270
and 300 in the primary tumor and metastases, respectively. 97.8% of pri-
mary tumors and 97.6% of metastases showed moderate or high Trop-2
expression.
Discussion: Nectin-4 expression in PC is less common compared to
other squamous cell carcinomas. Particularly advanced, more aggressive
tumors showed lower expression. In contrast, Trop-2 is more commonly
expressed in PC.
Conclusion: EV therapy may be useful for selected patients with Nectin-4
positive tumors. As Trop-2 is highly expressed in almost all PCs, it seems
a very interesting target for an ADC therapy with SG that has to be inves-
tigated in clinical trials. In parallel, preclinical studies are necessary to
evaluate the rationale and biological eects of these new promising ther-
apeutic options.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts240
1026
Big data analytics with routine claims data according to §21
KHEntgG for method comparison in transurethral urothelial
carcinoma resection with and without photodynamic
diagnostics provides meaningful insights with real world data
Gerson Lüdecke1; Eva Bernauer2; Manuel Heurich2; Rita Lüdecke3
1UKGM Gießen GmbH, Klinik und Poliklinik für Urologie, Kinderurologie und
Andrologie, Gießen, Deutschland
2BinDoc GmbH, Tübingen, Deutschland
3mSE medizinische Software Entwicklung, Linden, Deutschland
Background:e hypothesis that photodynamic diagnostics (PDD) pro-
vides better results than white light (WL) resection in non-muscle-inva-
sive bladder cancer (NMIBC) will be tested using a representative sample
of German anonymizedroutine claims data according to §21 KHEntG.
e superiority of PDD is characterized by a higher indication for post-
resection as an indicator for high risk classication in NMIBC, a higher
percentage of D09.0, more 2-year recurrence free survival, fewer recur-
rence resections, longer interval until recurrence, and less cystectomy.
Methods:From the BinDoc research database, we take all patients with
OPS-Code 5-573.40 or 5-573.41 and main diagnosis C67.n or D09.0
between 2019 and 2022. We make sure that a patient hasn’t been treated
up to 15 months before inclusion and that we can follow a patient for two
years from admission based on the patient’s hashed insurance ID. is
provides us with a sample of 1751 cases (PDD: 432, WL: 1319) from 38
clinics from 01/04/2020 until 31/12/2020. We compare percentages and
mean values of the quantities of interest from the PDD and the WL group,
with p-values calculated aer Pearsons chi-squared, Fisher’s exact test or
the Wilcoxon rank sum test.
Results:We nd that 35.19% of PDD and 25.25% of WL cases (p=0.0001)
get a post-resection; both groups were equal in the amount of D09.0
diagnosis (p=0.62) and risk of recurrence (34.03% and 30.17%; p=0.15);
whereas the mean time to recurrence (234 days for PDD versus 202 days
for WL (p=0.048)) is prolonged; and cystectomy rate is less likely among
PDD cases (9.72% to 14.40%; p=0.016).
Discussion:e results provide strong evidence that PDD is superior to
WL resection in NMIBC in terms of a stronger indication for post-resec-
tion, a longer time to recurrence, and a lower risk of cystectomy.
Conclusions: e analyses were conducted with billing data instead
of classical cancer registry data, and they were based on a sub-sam-
ple of German clinics and required a follow-up of each patient for two
years.Given these challenges, it is remarkable that we could show a supe-
riority of PDD compared to WL.
Disclosure Statement: e authors declare no conict of interest.
Gynecologic Cancer
1049
Cost-Eectiveness Studies Evaluating HPV Self-Sampling for
Cervical Cancer Screening – a Systematic Review
Lara Hallsson1; Marc Riedlsperger1; Anna-Maria Hoacher1;
LéonieHéloïseHaaf1,2,3; Milena Mühler1; Peter Hillemanns4;
MatthiasJentschke4; Uwe Siebert1,5,6; Gaby Sroczynski1
1Department of Public Health, Health Services Research, and Health Technology
Assessment, UMIT TIROL – University for Health Sciences and Technology, Hall
i.T., Österreich
2Institute for Medical Information Processing, Biometry and Epidemiology - IBE,
LMU Munich, Munich, Deutschland
3Pettenkofer School of Public Health, Munich, Deutschland
4Department of Gynaecology and Obstetrics, Hannover Medical School,
Hannover, Deutschland
5Center for Health Decision Science, Departments of Epidemiology and Health
Policy & Management, Harvard T. H. Chan School of Public Health, Boston, USA
6Institute for Technology Assessment and Department of Radiology,
Massachusetts General Hospital, Harvard Medical School, Boston, USA
To systematically evaluate studies investigating the cost eectiveness of a
possible implementation of human papillomavirus (HPV) self-sampling
(HPV-SS) for cervical cancer screening. Relevant databases (including
Medline (PubMed)) were searched (until 11/2023) for studies investigat-
ing the cost eectiveness of HPV-SS in cervical cancer screening in mid-
dle- and high-income countries in Europe. e PRISMA guidelines were
followed. Cohort studies, randomized controlled trials and decision-an-
alytic modeling studies published in English or German were included.
Key study characteristics (including author/year/country/currency/target
population/study type) and outcomes (e.g., incremental cost-eectiveness
ratios [ICER]) were extracted and reported into a standardized evidence
table. e study quality was assessed using the CHEERS checklist. e
original currency was converted to Euro (index year 2022) for cross-coun-
try comparison. Of 2,431 studies, eleven studies met the inclusion crite-
ria. ese included six model-based cost-eectiveness evaluations and
ve economic evaluations along trials and were primarily conducted in
high-income countries. All studies compared HPV-SS with standard care
(e.g., Pap smear/conventional cytology, clinician-collected HPV testing,
standard reminder letters to get screened). Only few studies investi-
gated HPV-SS in all screening-eligible women, most studies investigated
HPV-SS in women not attending regular screening. Direct home mailing
of the HPV-SS kit was the preferred method to reach women. ICERs were
reported in nine studies and ranged from 2,900 EURO per quality-ad-
justed life year (QALY) gained for the provision of HPV-SS-based screen-
ing for non-participants (Netherlands) to 90,200 EURO/QALY (Sweden)
for a combined strategy (cytology screening up to the age 35 years +
HPV test with HPV-SS from age 35 years). All studies showed HPV-SS
to increase screening participation. Screening with HPV-SS can be a cost-
eective, practical, and feasible approach to increase screening coverage.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 241
Head and Neck Cancer
1064
Exosomal miRNA as possible liquid biomarker for HPV+ Head
and Neck Squamous Cell Carcinoma
Maximilian Oberste1; Carla Apeltrath1; Armands Riders1; Frank Simon1;
Claudia Rudack1
1Universitätsklinikum Münster/Klinik für Hals-, Nasen- und Ohrenheilkunde,
Kopf- und Halschirurgie, Münster, Deutschland
Background: Head and neck squamous cell carcinomas (HNSCC) tend
to develop early lymphogenic metastasis, but reliable laboratory markers
are lacking.e determination of exosomal miRNA (miR) as part of a liq-
uid biopsy could be a new promising marker for prognosis and treatment
choice of HPV+ HNSCC.
Methods: In the period from June 2021 to August 2022, 66 patients (50
HNSCC/16 cancer free) were acquired at the ENT clinic at University hos-
pital Münster. Ablood sample was taken from the tumor population as
part of the panendoscopy and 12 months aer the initial diagnosis.e
exosomal miRNA load for miR-21, miR-1246, miR-let7a, miR-181a, and
miR-26a was determined using rt-PCR. e expression ratios of the six
miRNAs in reference to the tumor-free normal population were exam-
ined using mixed linear models for relationships with clinical parameters
(UICC, smoking and alcohol behavior, HPV status) and type of therapy.
Result: Exosomal miR-21 and miR-let7a were on average three times
higher expressed in HPV/p16+ HNSCC at initial diagnosis than in HPV/
p16- HNSCC (p<0.001; p=0.003). In comparison, exosomal miR-181a
was increased by an average of 2.4-fold (p=0.008). Aer 12 months, HPV/
p16+ HNSCC showed half the reduced expression of exosomal miR-
21 than in HPV/p16- patients (p=0.028). 22 patients (11 HPV+ and 11
HPV-) suered of an oropharyngeal carcinoma. In this subgroup the exo-
somal expression of miR-let-7a was on average more than threefold higher
(p=0.039) and that of miR-26a was more than vefold higher (p=0.041) in
patients without lymph node involvement (n=11) than in patients with N1
oder N2 stages (n=11).
Discussion: Exosomal miR-21, miR-let7a and miR-181a are signicantly
upregulated in HPV+ HNSCC compared to HPV- HNSCC at initial diag-
nosis. Furthermore, exosomal miR-let7a and miR-26a were signicantly
dierent in the oropharyngeal subgroup in relation to lymph node status
at initial diagnosis.
Conclusion: In our study, specic exosomal miRNAs are shown to be
potential liquid biomarkers for HPV+ HNSCC.
Disclosure Statement: e authors declare no conict of interest.
977
Blocking of Eag1 in OSCC
Susanne Wolfer1; Philipp Kaumann1; Henning Schliephake1; Luis Pardo2
1Universitätsmedizin Göttingen, Göttingen, Deutschland
2Max Planck Institut für Multidisziplinäre Naturwissenschaften, Göttingen,
Deutschland
Background: Eag1 (Kv10.1) is the rst voltage-dependent potassium
channel to be linked to tumorigenesis and detected in a variety of human
malignancies 1. In previous studies, we were able to document Eag1 in
OSCC for the rst time 2. Astemizole and imipramine are inhibitors of
Eag1, but they also block similar cardiac channels (Ergs) 3. A targeted
induction of apoptosis of Eag1+ cancer cell lines using TRAIL-constructs
was described 4. In this study, we investigated the impact of blocking Eag1
on OSCC cell lines.
Methods: Induction of apoptosis by astemizole (5µM), imipramine
(25µM) and Eag1 Antibody-TRAIL fusions (scFv62-scTRAIL or VHH-
D9-scTRAIL, 150 pM) was determined in the cell lines HN and SCC-081.
Apoptosis was monitored using caspase-3/7 activity in a live cell imaging
Incucyte system. Functional expression of Eag1 and the eect of blocking
were tested using patch clamp in cells in culture.
Result: Aer the addition of imipramine and astemizole, an increased
apoptosis rate could be detected (astemizole: HN p < 0.001, SCC081 p <
0.0001; imipramine: HN p < 0.0001, SCC081 p < 0.0001). e functional
expression of Eag1 and its blocking by astemizole and imipramine were
conrmed using pach clamp in HN cells. To date, no targeted induction
of apoptosis could be demonstrated with the TRAIL-constructs in OSCC.
Discussion: e blocking of Eag1 has been described in some ways 3.
Aer the initial detection of Eag1, we were now also able to demonstrate
the function and blocking of this channel in OSCC, which provides an
important basis for further therapy-relevant research.
Conclusion: Inhibition of Eag1 (Kv10.1) is possible in OSCC in vitro
using astemizole and imipramine. Further studies to demonstrate a tar-
geted blocking using TRAIL-constructs are still necessary.
References:
1 Pardo, L.A. et al. 1999, EMBO J. 18, 5540-5547
2 Wolfer et al. 2022, Oncol Res Treat 2022;45
3 Toplak et al. 2022 Med Res Rev. Jan; 42(1):183-226
4 Hartung et al. 2020 Front Pharmacol. May 14;11:686
Disclosure Statement: e authors declare no conict of interest.
Health Economy/Public Health
1134
Evaluation of Long-term Benets, Harms and Cost-
Eectiveness of Including HPV Self-Sampling Oered to
Non-Attendees of the Organized Cervical Cancer Screening
Program in Germany
Gaby Sroczynski1; Lara Hallsson1; Milena Mühler1; Peter Hillemanns2;
Matthias Jentschke2; Uwe Siebert1,3,4
1Department of Public Health, Health Services Research, and Health Technology
Assessment, UMIT TIROL – University for Health Sciences and Technology, Hall
in Tirol, Österreich
2Department of Gynaecology and Obstetrics, Hannover Medical School,
Hannover, Deutschland
3Center for Health Decision Science, Departments of Epidemiology and Health
Policy & Management, Harvard T. H. Chan School of Public Health, Boston, USA
4Institute for Technology Assessment and Department of Radiology,
Massachusetts General Hospital, Harvard Medical School, Boston, USA
Background: We systematically evaluated benets, risks, and cost-ef-
fectiveness of dierent cervical cancer screening strategies oering
additionally Human papillomavirus (HPV) self-sampling (HPV-SS) to
non-attendees.
Methods: A validated Markov model for the German context was used to
evaluate additional HPV-SS for non-attendees age 25-65, 30-65 or 35-65
years, every ve years with regular invitation, either Opt-in (invitation with
link to order test), or Send-to-all (test sent with invitation) compared to stan-
dard CC screening alone. German clinical, epidemiological, economic data
(indexed 2022/23), along with test accuracy and HPV-SS-attendance data
from international meta-analyses and trials were incorporated. Outcomes
included undiscounted life-years gained (LYG), and positive test results (PT)
per 1000 women compared to standard screening without HPV-SS, and the
incremental cost-eectiveness ratio (ICER; in EUR/LYG). Comprehensive
sensitivity analyses were conducted to check the robustness of ndings.
Result: Incremental undiscounted LYG (PT) per 1000 women (each
compared to standard screening without HPV-SS) ranged between 0.90
LYG (28 PT) for oering with ve-yearly screening invitation an HPV-SS
(Opt-in) to non-attendees age 35-65 and 1.67 (62 PT) for HPV-SS (send-
to-all) age 30-65 or age 25-65 years. Corresponding discounted ICERs
(compared to next eective) for non-dominated HPV-SS screening strat-
egies were 22,700 EUR/LYG for HPV-SS (Opt-in) age 35-65, 25,900 EUR/
LYG for HPV-SS (send-to-all) age 35-65, 726,000 EUR/LYG for HPV-SS
(send-to-all) age 30-65, and 1.78 mio. EUR/LYG for HPV-SS (send-to-
all) age 25-65 years. Other Opt-in strategies were dominated. Results were
robust over a wide range of parameter variations.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts242
Discussion/Conclusion: Oering HPV-SS (Send-to-all) to non-attendees
every ve years as of age 35 as an additional strategy within the organ-
ised CC screening program is eective and cost- eective. Findings can
be used to inform decision-makers and clinical guideline developers in
Germany.
Disclosure Statement: e authors declare the following: is work was carried
out as part of the HaSCo study (Hanover Self-Collection Study for the Prevention
of Cervical Cancer) which was funded by a grant of the Deutsche Krebshilfe.
1137
Working-age cancer: association between sociodemographic,
clinical and patient-related characteristics and the risk of
earning incapacity
Sarah Schröer1; Melanie Kolb1; Kerstin Garbrock1; Vera Ries1;
Klaus-PeterThiele1
1Medizinischer Dienst Nordrhein, Düsseldorf, Deutschland
Background: A third of cancer cases in Germany aect people of working
age. Health impairments due to the disease or therapy may risk occupa-
tional participation. e study investigates 1. which tumor sites predomi-
nantly lead to an assessment of earning capacity by the Medical Service, 2.
how oen a reduction in earning capacity is conrmed, and what associa-
tions exist with patient characteristics.
Methods: e study is based on routine data from expertise carried out by
the North Rhine Medical Service for statutory health insurance between
01.01.22 and 19.11.23 on men and women diagnosed with cancer (C00-97
w/o C44) of working age (20-64 years). e primary outcome was con-
rmed reduction of earning capacity; associations with age, gender, occu-
pation, fatigue, tumor stage, need for care and mental comorbidity were
tested by Pearsons chi squared test.
Results: During the observation period 2525 people (58% women) were
assessed. Most frequently assessed tumor sites in women are breast (37%),
lung (11%), secondary tumors (9%), in men lung (14%), secondary
tumors (13%), colon (12%). Compared to proportionate frequencies of
cancer incidence, brain tumors (+129% women, +127% men) and multi-
ple myeloma (+97% women, +107% men) are examined more frequently.
Malignant melanomas (women -78%, men -74%), thyroid cancer (women
-88%, men -68%) and, in men, carcinomas of prostate (-61%) and testicles
(-75%) were assessed less frequently. Reduced earning capacity was more
common in lung (39%) and pancreatic cancer (40%) than in breast can-
cer (18%). For most cancers, reduced earning capacity was signicantly
associated with tumor stage and need of care. Fatigue, polyneuropathy
and mental comorbidity showed signicant association in some cancers.
Discussion & Conclusion: e proportion of cancer patients aected by
reduced earning capacity varies between tumor sites, but also with patient
characteristics. Addressing this challenge is of great relevance for service
providers, employers and health politics, not least in view of demographic
developments and the shortage of skilled workers.
Disclosure Statement: e authors declare no conict of interest.
Hematooncology including Bone marrow
transplantation, Lymphoma, Plasmocytoma
966
Secondary immunodeciencies and susceptibility to
infections in patients with non-Hodgkin’s lymphomas during
anti-CD20-antibody containing treatments
Stefan Feiten1; Ursula Vehling-Kaiser2; Johannes Mohm3;
MichaelGärtner4; Jörg Lipke5; Karl Verpoort6; Achim Rothe7; Rudolf Weide8
1Institut für Versorgungsforschung in der Onkologie, Koblenz, Deutschland
2ÜBAG MVZ Dr. Vehling-Kaiser GmbH, Landshut, Deutschland
3Gemeinschaftspraxis Dres. Mohm, Prange-Krex, Dresden, Deutschland
4Onkologisches Ambulanzzentrum (OAZ), Hannover, Deutschland
5Gemeinschaftspraxis für Hämatologie und Onkologie, Dortmund, Deutschland
6Schwerpunkt Hämatologie, Onkologie und Palliativmedizin, Hamburg,
Deutschland
7MVZ West GmbH, Köln, Deutschland
8Praxis für Hämatologie und Onkologie, Koblenz, Deutschland
Background: Only limited real-world data exist about immune status and
susceptibility to infections in correlation to anti-CD20-antibody contain-
ing therapies in non-Hodgkins lymphoma (NHL) patients.
Methods: Multicenter prospective analysis of 52 NHL patients who
started anti-CD20-antibody containing treatments between 04/21 and
11/22. With the help of patient diaries infections over the course of one
year were captured. Additionally, diagnosis and treatment data were
extracted from medical records retrospectively. Data was statistically ana-
lyzed using SPSS 29.
Result: So far 52 patients with a median age of 68.5 (32-90) could be
analyzed. 54% were male, 46% female. 27% suered from follicular lym-
phoma, 25% from CLL and 58% from other NHL. During the observa-
tion period 4 patients (8%) died, 2 of them from an infection. e most
frequently used protocols were R-CHO(E)P (31%), BR (27%) and ritux-
imab mono (13%). A quantitative determination of T helper cells (CD4
lymphocytes) was carried out in only 11 patients (21%). A comparison
of the mean values across all measurements before and aer the start of
treatment showed a clear dierence (1,217/µl vs. 478/µl) (p=.052). In 17
patients (33%) a quantitative determination of the IgG trough level was
carried out. Mean values across all measurements before (831mg/dl) and
aer the start of therapy (701mg/dl) were not statistically signicantly dif-
ferent (p=.124). Standardized to 1,000 days, the mean number of infec-
tions before treatment was 2.57 compared to 6.86 across all measurements
aer the start of therapy (p<.001).
Discussion: Infectious complications are increased during anti-CD20-an-
tibody therapies in routine care. Immune monitoring is only performed in
a minority of patients.
Conclusion: We suggest that immune monitoring with measurement of
serum IgG-levels, IgG-subclasses and T helper cell counts should be part
of routine laboratory analysis during NHL therapy to enable prophylactic
and timely actions preventing serious infectious complications.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 243
1051
Ecacy and safety of luspatercept versus epoetin alfa (EA) in
erythropoiesis-stimulating agent (ESA)-naive patients (pts)
with transfusion-dependent (TD) lower-risk myelodysplastic
syndromes (LR-MDS): full analysis of the COMMANDS trial
Uwe Platzbecker1; Guillermo Garcia-Manero2; Valeria Santini3;
Amer M. Zeidan4; Pierre Fenaux5; Rami S. Komrokji6; Jake Shortt7;
DavidValcárcel8; Anna Jonášová9; Sophie Dimicoli-Salazar10;
Ing Soo Tiong11; Chien-Chin Lin12; Jiahui LI13; Jennie Zhang13;
Ana Carolina Giuseppi13; Sandra Kreitz14; Veronika Pozharskaya13;
Karen L. Keeperman13; Shelonitda Rose13; Thomas Prebet13;
Andrius Degulys15,16; Stefania Paolini17; Thomas Cluzeau18;
Matteo Giovanni Porta19,20
1Medical Clinic and Policlinic 1, Hematology and Cellular Therapy, University
Hospital Leipzig, Leipzig, Deutschland
2Department of Leukemia, The University of Texas MD Anderson Cancer Center,
Houston, USA
3MDS Unit, DMSC, Azienda Ospedaliero-Universitaria Careggi, University of
Florence, Florence, Italien
4Department of Internal Medicine, Yale School of Medicine and Yale Cancer
Center, Yale University, New Haven, USA
5Service d’Hématologie Séniors, Hôpital Saint-Louis, Université Paris, Paris,
Frankreich
6Mott Cancer Center, Tampa, USA
7Monash University and Monash Health, Melbourne, Australien
8Hospital Universitari Vall d’Hebron, Barcelona, Spanien
9Medical Department Hematology, Charles University General University
Hospital, Prague, Tschechische Republik
10Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux,
Bordeaux, Frankreich
11Malignant Haematology & Stem Cell Transplantation, The Alfred, Melbourne,
Australien
12Department of Laboratory Medicine, National Taiwan University Hospital,
Taipei, Taiwan
13Bristol Myers Squibb, Princeton, USA
14Celgene International Sàrl, a Bristol-Myers Squibb Company, Boudry, Schweiz
15Hematology, Oncology and Transfusion Medicine Center, Vilnius University
Hospital Santaros Klinikos, Vilnius, Lithuania
16Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius,
Lithuania
17IRCCS Azienda Ospedaliero-Universitaria di Bologna - Istituto di Ematologia
“Seràgnoli”, Bologna, Italien
18Département d’Hématologie Clinique, Université Cote d’Azur, CHU Nice, Nice,
Frankreich
19Cancer Center IRCCS Humanitas Research Hospital, Milan, Italien
20Department of Biomedical Sciences, Humanitas University, Milan, Italien
Background: ESAs are an established treatment (tx) for pts with TD
LR-MDS, yet outcomes are poor. In the preplanned interim analysis of the
phase 3 COMMANDS trial (NCT03682536) comparing luspatercept with
EA for the tx of anemia in ESA-naive TD pts with LR-MDS, luspatercept
showed superiority over EA in improving red blood cell transfusion inde-
pendence (RBC-TI) rates (Platzbecker U, et al. Lancet 2023;402:373-385).
Here, we report the full ecacy and safety analysis of the COMMANDS trial.
Methods: Eligible pts were aged ≥ 18 years, had Revised International
Prognostic Scoring System-dened LR-MDS, serum erythropoietin < 500
U/L, were TD (received 2–6 RBC U/8 weeks [wk] for ≥ 8 wk before ran-
domization) and ESA-naive. Pts, randomized 1:1, received luspatercept
(1.0–1.75 mg/kg) subcutaneously (SC) Q3W, or EA (450–1050 IU/kg) SC
Q1W for ≥ 24 wk. Primary endpoint was RBC-TI ≥ 12 wk with a concur-
rent mean hemoglobin (Hb) increase of ≥ 1.5 g/dL (wk 1–24).
Result: As of Mar 31, 2023, 182 pts were randomized to luspatercept and
181 to EA; median tx duration (range) was 51.3 (3–196) and 37.0 (1–202)
wk and median follow-up (range) was 17.2 (1–46) and 16.9 (0–46) months,
respectively. In the luspatercept arm, 110 (60.4%) pts achieved the pri-
mary endpoint versus 63 (34.8%) in the EA arm (P < 0.0001). Overall,
178 (97.8%) and 165 (92.2%) pts receiving luspatercept and EA reported
tx emergent adverse events (TEAEs) of any grade; 107 (58.8%) and 88
(49.2%) pts reported grade 3/4 TEAEs, respectively. In both tx arms, rates
of AML progression (2.7% and 3.3%, in the luspatercept arm versus the
EA arm), and rates of on- and post-tx deaths were similar.
Discussion: Superior primary endpoint response rates and RBC-TI
duration were seen with luspatercept versus EA. ese results conrm
the interim analysis ndings; safety results were consistent with previous
MDS studies.
Conclusion: Luspatercept could be a new standard of care for pts with TD
LR-MDS. Abstract presented at ASH 2023. Garcia-Manero G, et al. Blood
2023;142[suppl 1]. Abstract 193). © American Society of Hematology
(2023). Reused with permission.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
Lung Cancer
1018
ALINA: ecacy and safety of adjuvant alectinib versus
chemotherapy in patients with early-stage ALK+ non-small
cell lung cancer (NSCLC)
Rajiv Shah1; Benjamin J. Solomon2; Jin Seok Ahn3; Rafal Dziadziuszko4;
Fabrice Barlesi5; Makoto Nishio6; Dae Ho Lee7; Jong-Seok Lee8;
WenzhaoZhong9; Hidehito Horinouchi10; Weimin Mao11;
MaximilianHochmair12; Filippo de Marinis13; Maria Rita Migliorino14;
IgorBondarenko15; Tania Ochi Lohmann16; Tingting Xu17;
AndresCardona18; Walter Bordogna19; Thorsten Ruf20; Yi-Long Wu9
1Dept. of Thoracic Oncology, Thoraxklinik, Heidelberg University Hospital and
National Center for Tumor Diseases (NCT), NCT Heidelberg, Translational Lung
Research Center Heidelberg (TLRC-H), Heidelberg, Germany
2Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne
Australia
3Department of Hematology & Oncology, Samsung Medical Center, Seoul,
Republic of Korea
4Department of Oncology & Radiotherapy and Early Phase Clinical Trials Centre,
Medical University of Gdansk, Gdańsk, Poland
5Department of Medical Oncology, International Center for Thoracic Cancers
(CICT), Gustave Roussy,Saclay University, Faculty of Medicine, Kremlin-Bicêtre,
France
6Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake,
Koto, Tokyo, Japan
7Department of Oncology, Asan Medical Center, Seoul, Republic of Korea
8Division of Hematology and Medical Oncology, Department of Internal
Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of
Korea
9Guangdong Lung Cancer Institute, Guangdong Provincial People’s Hospital
(Guangdong Academy of Medical Sciences), Southern Medical University,
Guangzhou, China
10Department of Thoracic Oncology, National Cancer Center Hospital, Chuo City,
Tokyo, Japan
11Institute of Basic Medicine and Cancer, Chinese Academy of Sciences,
Zhejiang, China
12Department of Respiratory & Critical Care Medicine, Klinik Floridsdorf,
Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Vienna,
Austria
13Thoracic Oncology Division, European Institute of Oncology (IRCSS), Milan,
Italy
14Pneumo-Oncology Unit, San Camillo Forlanini Hospital, Roma, Italy
15Oncology and Medical Radiology Department, Dnipropetrovsk Medical
Academy, Dnipro, Ukraine
16PD Oncology, F. Homann-La Roche Ltd, Basel, Switzerland
17Department of Clinical Science, Roche (China) Holding Ltd, Shanghai, China
18Data and Statistical Sciences, F. Homann-La Roche Ltd, Basel, Switzerland
19Product Development Medical Aairs, F. Homann-La Roche Ltd, Basel,
Switzerland
20PD Safety Risk Management, F. Homann-La Roche Ltd, Basel, Switzerland
Background: Current standard of care for patients (pts) with resected,
stage IB–IIIA, ALK+ NSCLC, is adjuvant platinum-based chemotherapy
(CT), which is associated with only modest survival benet. Alectinib is a
preferred rst-line treatment in advanced ALK+ NSCLC. Here, we report
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts244
data from the prespecied interim analysis of ALINA (NCT03456076), a
global, phase III, open-label, randomised trial assessing the ecacy and
safety of adjuvant alectinib compared with CT in pts with completely
resected ALK+ NSCLC.
Methods: Eligible pts were ≥18 years old, had an ECOG PS of 0/1 and
completely resected, stage IB (≥4 cm)–IIIA, ALK+ NSCLC (per UICC 7th
edition). Pts were randomised 1:1 to receive either oral alectinib for 24
months (or until disease recurrence, unacceptable toxicity, or withdrawal
of consent), or up to four cycles of platinum-based CT. Randomisation
was stratied by stage (IB vs II vs IIIA) and race (Asian vs non-Asian).
Primary endpoint: investigator-assessed disease-free survival (DFS),
tested hierarchically rst in the stage II–IIIA and then in the ITT popu-
lation (stage IB–IIIA). Other endpoints included: CNS-DFS, overall sur-
vival (OS), safety.
Result: 257 pts were randomised to receive alectinib (n=130) or CT
(n=127); baseline characteristics were well balanced between arms. At
data cuto (26 June 2023), median follow up was 27.8 months. A signi-
cant DFS benet was observed with alectinib vs CT in both the stage II–
IIIA (HR 0.24; 95% CI: 0.13–0.45) and ITT populations (HR 0.24; 95% CI:
0.13–0.43; table). e DFS benet was maintained across all subgroups.
A clinically meaningful CNS-DFS benet was observed in the ITT pop-
ulation (HR 0.22; 95% CI 0.08–0.58). OS data were immature. No unex-
pected safety ndings were observed.
Discussion: Alectinib signicantly improves DFS compared with CT in
pts with completely resected ALK+ NSCLC and prevents dicult to treat
CNS relapses
Conclusion: Alectinib oers an eective new treatment strategy for pts
with resected ALK+ NSCLC.
Previously presented at ESMO, LBA2, Benjamin J. Solomon et al. - Reused with
permission
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
1126
Outcomes and Side Eects of Image-Guided Single-Dose
Stereotactic Radiotherapy for Lung Tumors
Kerem Tas1; Hilke Vorwerk1; Sebastian Adeberg1; Ahmed Gawish1
1Universitätsklinikum Gießen und Marburg, Marburg, Deutschland
Background: is research sought to present preliminary ndings from
the use of single-dose stereotactic radiotherapy (RT) in treating patients
with inoperable lung tumors.
Methods: At our center, patients received treatment using single-dose
SBRT (25 Gy and 30 Gy, 80% isodose). e study encompassed patients
with inoperable T1-2N0 non-small cell lung cancer (NSCLC) or isolated
lung metastases. e SBRT was administered during a gated breath-hold
with a planning target volume (PTV) margin set between 3-5 mm. Real-
time CBCT scans were evaluated to assess the accuracy and ecacy of the
gated delivery method.
Result: e study involved 95 patients presenting 120 lesions (comprising
61 NSCLC and 59 metastatic tumors). Among the entire cohort, 23 out
of 120 lesions experienced local failure. Local control rates over 12, 24,
and 36 months were 88%, 82%, and 75%, respectively. Within the NSCLC
group, 9 out of 61 lesions showed in-eld failures, with local control rates
at 12, 24, and 36 months being 94%, 85%, and 80%. Meanwhile, for the
group with pulmonary metastases, 14 out of 59 lesions experienced local
failure, and the control rates over 12, 24, and 36 months were 80%, 75%,
and 65%, respectively. Only 6 out of 95 patients exhibited Grade II pneu-
monitis. No patient displayed Grade 3 or 4 toxicities.
Conclusion: Administering single-dose stereotactic RT appears viable for
specic lung tumor patients. A higher dosage correlated with enhanced
local control. Extended observation is essential to fully gauge the treat-
ments eectiveness and associated side eects.
Disclosure Statement: e authors declare no conict of interest.
1056
Sacituzumab Govitecan + Pembrolizumab in 1L Metastatic
Non-Small Cell Lung Cancer: Preliminary Results of the
EVOKE-02 Study
Niels Reinmuth1; Byoung Chul Cho2; Manuel Cobo Dols3;
Roxana Reyes Cabanillas4; David Vicente Baz5; Jose Fuentes Pradera6;
Salvatore Grisanti7; Afshin Eli Gabayan8; Ki Hyeong Lee9; Eun Kyung Cho10;
Sabeen Mekan11; Farnoush Safavi11; Nelumka Fernando11;
Michael J. Chisamore12; Martin Reck13
1Asklepios Fachkliniken München-Gauting, Gauting, Deutschland
2Yonsei Cancer Center, Seoul, Republik Korea
3Regional and Virgen de la Victoria University Hospitals, Malaga, Spanien
4Hospital Clinic de Barcelona, Barcelona, Spanien
5Hospital Universitario Virgen Macarena, Seville, Spanien
6Hospital Universitario Virgen de Valme, Seville, Spanien
7Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italien
8Beverly Hills Cancer Center, Beverly Hills, USA
9Chungbuk National University Hospital, Chungbuk, Republik Korea
10Gachon University Gil Medical Center, Incheon, Republik Korea
11Gilead Sciences, Inc, Foster City, USA
12Merck & Co., Inc., Rahway, USA
13Airway Research Center North, German Center for Lung Research (DZL),
LungenClinic, Grosshansdorf, Deutschland
Background: PD-[L]1 inhibitor–based regimens are the current standard
of care in rst line (1L) mNSCLC and novel combinations are needed.
Sacituzumab govitecan (SG), a Trop-2-directed ADC, demonstrated clin-
ical activity and manageable safety in pretreated patients (pts) with mNS-
CLC. e ongoing, global, open-label, multicohort, Phase 2 EVOKE-02
study (NCT05186974) is evaluating SG + pembrolizumab (pembro) ±
platinum agent as 1L treatment for mNSCLC. Here, we report preliminary
results of pts treated with SG + pembro in Cohorts A and B.
Methods: Adults with previously untreated mNSCLC, no actionable
genomic alterations and an ECOG of 0 or 1 can enroll in Cohorts A or
B. Pts with PD-L1 TPS ≥50% (Cohort A) and <50% (Cohort B) receive
SG 10 mg/kg on day 1 and 8 + pembro 200 mg on day 1 of a 21-day cycle.
Trial endpoints include ORR (per RECIST v1.1), PFS, DoR, DCR, OS and
safety. Safety results are reported in pts who received ≥1 dose of study
treatment and ecacy results are reported in pts with ≥13.0 weeks of
follow-up.
Result: As of 13.01.23, 44 enrolled pts (Cohort A, n=16; Cohort B, n=28)
received SG + pembro. Median age was 68 y (range 47-80); 64% of pts had
non-squamous histology and 77% had an ECOG of 1. In ecacy-evalu-
able pts (Cohort A n=8; Cohort B n=18), ORR by investigator assessment
was 75% (5 conrmed PRs, 1 PR pending conrmation) in Cohort A and
44% (7 conrmed PRs, 1 PR pending conrmation) in Cohort B. Among
safety-evaluable pts (n=44), the incidence of any-grade treatment-emer-
gent AEs (TEAEs) was 96% (grade 3/4, 52%). Most common any-grade
TEAEs were diarrhea (50%), anemia (41%), asthenia (36%) and neutro-
penia (32%). TEAEs leading to discontinuation of SG occurred in 7% of
pts. TEAEs leading to death were reported in 3 (7%) pts, and only 1 (2%)
was considered related to study treatment.
Discussion/Conclusion: In Cohorts A and B, SG + pembro demonstrated
encouraging early ecacy with a manageable safety prole in pts with
mNSCLC. Additional results with more pts and longer follow up will be
presented.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 245
989
Datopotamab deruxtecan (Dato-DXd) vs docetaxel in
previously treated advanced/metastatic (adv/met) non-small
cell lung cancer (NSCLC): Results of the randomized phase III
study TROPION-Lung01
Akin Atmaca1,1; Myung-Ju Ahn2; Aaron Lisberg3; Luis Paz-Ares4;
Robin Cornelissen5; Nicolas Girard6; Elvire Pons-Tostivint6;
David Vicente Baz4; Shunichi Sugawara9; Manuel Angel Cobo4;
Maurice Pérol6; Céline Mascaux6; Elena Poddubskaya13; Satoru Kitazono9;
Hidetoshi Hayashi9; Jacob Sands3; Richard Hall3; Yong Zhang3;
Hong Zebger-Gong1; Deise Uema3; Isamu Okamoto9; Niels Reinmuth1
1Krankenhaus Nordwest, Frankfurt am Main, Deutschland
2Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul,
Seoul, South Korea
3David Geen School of Medicine at UCLA, Los Angeles, USA
4Hospital Universitario 12 de Octubre, CNIO-H12O Lung Cancer Unit,
Universidad Complutense & CiberOnc, Madrid, Spain
5Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands
6Institut Curie, Paris, France
7Centre Hospitalier Universitaire de Nantes, Nantes, France
8Hospital Universitario Virgen Macarena, Seville, Spain
9Sendai Kousei Hospital, Sendai, Japan
10FEA Oncología Médica. Medical Oncology Intercenter Unit. Regional and
Virgen de la Victoria University Hospitals. IBIMA, Málaga, Spain
11Centre Léon Bérard, Lyon, France
12Hôpitaux Universitaires de Strasbourg (CHRU), Strasbourg, France
13Vitamed LLC, Moscow, Russia
1The Cancer Institute Hospital of JFCR, Tokyo, Japan
15Kindai University, Osaka, Japan
16Dana-Farber Cancer Institute, Boston, USA
17University of Virginia Health System, Charlottesville, USA
18Daiichi Sankyo, Inc, Basking Ridge, USA
19Daiichi Sankyo Europe GmbH, München, Germany
20Kyushu University Hospital, Fukuoka, Japan
21Asklepios Klinik Gauting GmbH, Gauting, Deutschland
Background: Dato-DXd is a novel TROP2-directed antibody-drug con-
jugate under clinical investigation in multiple tumor types. is is the
rst report of TROPION-Lung01 (NCT04656652), a randomized, global,
open-label, phase 3 study of Dato-DXd vs docetaxel (DTX) in pretreated
patients (pts) with adv/met NSCLC with or without actionable genomic
alterations (AGAs).
Methods: Pts were randomized 1:1 to Dato-DXd 6 mg/kg or DTX 75 mg/
m2 Q3W. Dual primary endpoints were progression-free survival (PFS;
by blinded independent central review [BICR]) and overall survival (OS).
Secondary endpoints included objective response rate (ORR), duration of
response (DOR), and safety.
Result: 604 pts were included in the full analysis set (FAS); 43.1% had
received ≥2 prior lines of systemic therapy. Median age was 64 y (range,
24-88). PFS was signicantly improved with Dato-DXd over DTX in
the FAS (HR, 0.75; 95% CI, 0.62-0.91; P=.004; median, 4.4 vs 3.7 mo).
Conrmed ORRs were 26.4% (Dato-DXd) and 12.8% (DTX), with median
DORs of 7.1 and 5.6 mo. Longer median PFS was observed in the prespec-
ied non-squamous histology subgroup (NSQ; 5.6 vs 3.7 mo). Median
treatment duration was 4.2 mo (range, 0.7-18.3 mo) for Dato-DXd and
2.8 mo (range, 0.7-18.9 mo) for DTX. e most common treatment-emer-
gent adverse events (TEAEs) seen with Dato-DXd were stomatitis (49.2%,
mostly grade [gr] 1/2) and nausea (37%). Adjudicated drug-related inter-
stitial lung disease gr ≥3 occurred in 3.4% of pts with Dato-DXd vs 1.4%
with DTX. Fewer drug-related gr ≥3 TEAEs and AEs leading to dose
reduction or discontinuation were seen with Dato-DXd vs DTX.
Conclusion: PFS was signicantly improved with Dato-DXd over DTX
in pts with pretreated adv/met NSCLC. NSQ patients appeared to derive
the most benet. Dato-DXd was well tolerated, with a manageable safety
prole. e trial is continuing until the nal OS analysis. M-J. Ahn and A.
Lisberg have equally contributed to the study. Funding Daiichi Sankyo, Inc.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
999
Overalls Survival from a Phase II Randomised Double-Blind
Trial (PERLA) of Dostarlimab (dostar) + Chemotherapy (CT) vs
Pembrolizumab (pembro) + CT in Metastatic Non-Squamous
NSCLC
Solange Peters1; Frank Griesinger2; Ana Laura Ortega Granados3;
Filippode Marinis4; Giuseppe Lo Russo5; Michael Schenker6;
EdurneArriola7; Juan Manuel Puig8; Dae Ho Lee9; Martin Reck10;
ZsoltSzijgyarto11; Elena Buss12; Neda Stjepanovic13; Sun Min Lim14
1Oncology Department, Centre Hospitalier Universitaire Vaudois, Lausanne
University, Lausanne, Switzerland
2Department of Hematology and Oncology, Pius-Hospital Oldenburg, University
Medicine Oldenburg, Oldenburg, Germany
3Medical Oncology Department, Hospital Universitario de Jaén, Jaén, Spain
4Division of Thoracic Oncology, Istituto Europeo di Oncologia (IRCCS), Milan,
Italy
5Medical Oncology Department, Thoracic Unit, Fondazione IRCCS Istituto
Nazionale dei Tumori, Milan, Italy
6Oncologie Medicala, Policlinica Sf. Nectarie, Centrul de Oncologie, Craiova,
Romania
7Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
8Oncología, Centro Polivalente de Asistencia e Investigación Clínica, CER San
Juan, San Juan, Argentina
9Department of Oncology, University of Ulsan, College of Medicine, Asan
Medical Center, Seoul, South Korea
10Lungen Clinic, Airway Research Center North, Center for Lung Research,
Grosshansdorf, Germany
11GSK, Stevenage, UK
12GSK, Baar, Switzerland
13GSK, Baar, Switzerland
14Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center,
Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Background: e Phase II PERLA trial (NCT04581824) was the rst
global randomized, double-blind, head-to-head study of two programmed
death (PD)-1 inhibitors in NSCLC. In the primary analysis, dostar + CT
met its primary endpoint of equivalence, with a favorable numerical trend
in overall response rate (ORR) and progression-free survival compared to
pembro + CT. Here we report overall survival (OS) analyses from PERLA.
Methods: Patients (pts) with metastatic NSCLC, documented PD-L1
status, absence of EGFR, ALK or other actionable genomic aberrations
determined locally, ECOG 0–1, and no prior systemic treatment were ran-
domised 1:1 to dostar 500 mg or pembro 200 mg Q3W IV up to 35 cycles,
combined with CT (4 cycles pemetrexed [pem; 500 mg/m2] + carboplatin
[AUC 5 mg/mL/min] or cisplatin [75 mg/m2], followed by pem up to 35
cycles) Q3W IV. e primary endpoint was ORR by blinded independent
central review (BICR). OS (secondary endpoint) and duration of response
(DoR) by BICR (exploratory endpoint) were determined by Kaplan-Meier
method, 95% condence intervals (CIs) by Brookmeyer-Crowley method
and hazard ratio by stratied Cox proportional hazard model.
Results: At data cut-o on 07 July 2023, 121 and 122 pts in the dostar +
CT and pembro + CT arms respectively, were randomised and treated. OS
maturity was 55% (134/243). Median OS was 19.4 mo (95% CI 14.5, NR)
in the dostar + CT arm vs 15.9 mo (95% CI 11.6, 19.3) in the pembro +
CT arm, aer median follow-up (IQR) of 20.7 (17.3, 24.0) and 21.6 (18.3,
24.1) mo respectively, with a similar trend across PD-L1 subgroups. e
ORR for Dostar + CT was 45% (95% CI: 36.4, 54.8) (4 CRs, 51 PRs), show-
ing a 6.04% dierence [95% CI: -1.95, 14.02] compared to 39% (95% CI:
30.6, 48.6) in Pembro + CT (6 CRs, 42 PRs).e median DoR in Dostar +
CT was 12.4 mo (95% CI: 8.3, 17.9), while in Pembro + CT, it was 14.4 mo
(95%CI: 9.7, NR) No new safety concerns were raised.
Conclusions: In this follow-up analysis, dostar + CT continues to demon-
strate strong clinical ecacy with no unexpected safety signals. In addi-
tion, a numerical trend in OS favoring dostar + CT vs pembro + CT was
observed.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts246
1108
Randomized phase 3 study of rst-line selpercatinib versus
chemotherapy and pembrolizumab in RET fusion-positive
NSCLC
Herbert Loong1; Koichi Goto2; Benjamin Solomon3; Keunchil Park4;
Maurice Pérol5; Edurne Arriola6; Silvia Novello7; Ying Cheng8;
AndreaArdizzoni9; Milena Mak10; Fernando Santini11; Yasir Elamin12;
Alexander Drilon11; Jürgen Wolf13; Baohui Han14; Hongmei Han15;
MinjiUh16; Tarun Puri16; Viktoriya Soldatenkova16; Caicun Zhou17
1Hong Kong University, Hong Kong, China, VR
2National Cancer Center Hospital East, Kashiwa, Japan
3Peter MacCallum Cancer Centre, Melbourne, Australien
4Samsung Medical Center, Seoul, Republik Korea
5Léon Bérard Center, Lyon, Frankreich
6Hospital del Mar, Barcelona, Spanien
7Università degli Studi di Torino, Torino, Italien
8Jilin Cancer Hospital, Changchun, China, VR
9IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italien
10Instituto D’Or de Pesquisa e Ensino: Faculdade, Pós-Graduação, MBA, São
Paulo SP, Sao Paulo, Brasilien
11Memorial Sloan-Kettering Cancer Center, New York, USA
12University of Texas MD Anderson Cancer Center, Houston, USA
13Uniklinik Köln, Köln, Deutschland
14Jiaotong-Universität Shanghai, Shanghai, China, VR
15Eli Lilly, Indianapolis, USA
16Eli Lilly and Company Corporate Center, Indianapolis, USA
17Tongji University Aliated Shanghai Pulmonary Hospital, Shanghai, China, VR
Background: Selpercatinib is a highly selective and potent brain penetrant
RET inhibitor, approved for treatment of advanced RET fusion-positive
(RET+) NSCLC.
Methods: LIBRETTO-431 (NCT04194944) is a randomized, open-label,
phase 3 trial comparing rst-line selpercatinib vs chemotherapy (cispla-
tin/carboplatin + pemetrexed) +/- pembrolizumab. e primary endpoint
of blinded independent central review (BICR)-assessed PFS was tested
rst in patients stratied by investigator’s intent to treat with pembroli-
zumab, if assigned to the control arm, (ITT-pembro) and then in the ITT
population.
Result: A total of 261 patients were enrolled from 23 countries. At a
median follow up of ~19 months, selpercatinib demonstrated superior
PFS vs control in the ITT-pembro (HR: 0.465, 95% CI: 0.309, 0.699;
p-value: 0.0002) and ITT populations (HR: 0.482, 95% CI: 0.331, 0.700;
p-value: 0.0001). In the ITT-pembro population, median PFS was 24.8
months (95% CI: 16.9, NE) with selpercatinib vs 11.2 months (95% CI:
8.8, 16.8) with control. Clinically meaningful improvements in ORR,
DOR, and intracranial response were also observed with selpercatinib vs
control. Adverse events observed with selpercatinib and the control arm
were generally consistent with those previously reported.
Discussion: Selpercatinib achieved a statistically signicant and clinically
meaningful improvement in PFS compared to chemotherapy + pembroli-
zumab in advanced RET+ NSCLC.
Conclusion: ese data support comprehensive genomic testing at diag-
nosis and treatment with rst-line selpercatinib in patients with advanced
RET+ NSCLC.
Disclosure Statement: e authors declare the following: Mitglied in Beratungs-
gremine, Forschungsunterstützungen, Drittmittel
1131
Patient-reported outcomes of rst-line selpercatinib versus
chemotherapy with or without pembrolizumab in ret fusion-
positive advanced non-small-cell lung cancer: interim analysis
of LIBRETTO-431
Koichi Goto1; Silvia Novello2; Pilar Garrido3; Christophe Dooms4;
JorgeAlatorre-Alexander5; Niels Reinmuth6; Adrienne Gilligan7;
NalinPayakachat7; Aimee Bence-Lin7; Kim Cocks8; Gill Worthy8;
CaicunZhou9
1National Cancer Center Hospital East, Kashiwa, Japan
2Università degli Studi di Torino, Torino, Italien
3Ramón y Cajal Hospital, Madrid, Spanien
4Department of Respiratory Diseases, University Hospitals KU Leuven, Leuven,
Belgien
5Health Pharma Professional Research S.A de C.V., Ciudad de México, Mexiko
6Asklepios Lung Clinic, member of the German Center for Lung Research (DZL),
Munich-Gauting, Deutschland
7Eli Lilly and Company Corporate Center, Indianapolis, USA
8Adelphi Values, Bollington, United Kingdom
9Tongji University Aliated Shanghai Pulmonary Hospital, Shanghai, China, VR
Background: Selpercatinib, a highly selective and potent CNS penetrant
RET inhibitor has been approved for treatment of advanced RET fusion+
non-small-cell lung cancer (NSCLC). LIBRETTO-431 (NCT04194944),
is a randomized, phase 3 trial comparing rst-line selpercatinib to plat-
inum-based chemotherapy +/- pembrolizumab (pembro). is analysis
describes the patient-reported outcomes (PROs) from LIBRETTO-431.
Methods: PRO data (data cut-o: 01 May 2023) were evaluated for the
intent-to-treat (ITT) population and the subgroup of patients that received
pembro (ITT-pembro). Time to conrmed deterioration (TTCD) of pul-
monary symptoms (using NSCLC-Symptom Assessment Questionnaire
[SAQ]) and physical function (using EORTC QLQ-C30 Physical Function
scale [QLQ-C30 PF]) was time from randomization to the rst ≥2 point
increase of NSCLC-SAQ total score or ≥5 point decrease in QLQ-C30
PF, conrmed at next assessment. TTCD was compared between treat-
ment groups using log rank test and Cox proportional hazards model.
Symptomatic adverse events (using PRO version of the CTCAE item
library) were reported descriptively as baseline-adjusted worst score.
PROs were also analyzed for East Asia vs. non-East Asia subgroups.
Result: In ITT-pembro (selpercatinib n=129 and control n=83), selper-
catinib delayed TTCD of pulmonary symptoms (hazard ratio [HR]=0.34,
95% CI: 0.20-0.55) and physical function (HR=0.54, 95% CI: 0.39-0.75).
Patients in the selpercatinib arm reported worse PRO-CTCAE scores of
dry mouth, diarrhea, and arm/leg swelling, whereas those in the control
arm reported worse scores of nausea, fatigue, and decreased appetite.
Results were consistent in the ITT population. PROs were similar between
East Asia and non-East Asia subgroups.
Discussion: PRO data were consistent with the favorable ecacy of selp-
ercatinib compared with platinum-based chemotherapy +/- pembro.
Conclusion: Selpercatinib signicantly delayed TTCD of pulmonary
symptoms and physical function and was well-tolerated in these patient
populations.
Disclosure Statement: e authors declare the following: Mitgliedscha in Bera-
tungsgremien, Forschungsunterstützung, Drittmittel
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 247
Molecular Pathology
1129
Targeted RNAseq Analysis in Esophageal Cancers:
Implications for Neoadjuvant Therapy
Michelle Schulz1; Nadine Dexheimer2; Silke Mitschke2; Wilfried Roth2;
Michael Kloth2
1Klinik für Kinder- und Jugendmedizin, Klinikum der Goethe-Universität
Frankfurt am Main, Frankfurt am Main, Deutschland
2Institut für Allgemeine Pathologie, Universitätsmedizin der Johannes
Gutenberg- Universität Mainz, Mainz, Deutschland
Background: Esophageal adenocarcinoma (AC) and squamous cell car-
cinoma (SCC) frequently present with poor prognoses. is study aims
to evaluate the feasibility and prognostic signicance of targeted RNA
sequencing (RNAseq) in biopsy samples from these carcinomas, aiming
to rise a nuanced understanding of tumor biology and treatment response
by a more detailed pretherapeutic expression proling.
Methods: A retrospective analysis was conducted on paran-embed-
ded biopsy samples from patients who underwent neoadjuvant therapy,
that allowed a comparison of molecular proles pre- and post-treatment.
Prognostic modeling was performed using a machine learning-based
approach, leveraging gene expression data. It included pathway enrich-
ment analysis to elucidate underlying biological mechanisms.
Results: e feasibility of conducting RNAseq on small biopsy samples
was demonstrated, eectively distinguishing between SCC and AC sub-
types. SCCs were found to respond better to neoadjuvant treatment and
show a higher 5-year survival rate compared to ACs. Several prognostic
genes and pathways were identied, some of which may represent novel
ndings in the context of esophageal cancers. e machine learning
model identied a gene signature that signicantly enhanced prognostic
predictions.
Discussion: e ability to dierentiate between carcinomas using
RNAseq and to identify prognostic markers has signicant clinical impli-
cations. is approach enhances tumor molecular characterization, lead-
ing to more personalized and eective treatments. RNAseq complements
immunohistochemical quantication of markers like Her2/ERBB2 and
PD-L1, oering a more comprehensive molecular prole of tumors.
Conclusion: is study highlights the practicality and prognostic value
of targeted RNAseq in esophageal transition zone carcinomas but also
underscores its potential applicability in advancing personalized oncol-
ogy. Such insights pave the way for improved patient stratication and
personalized neoadjuvant therapy approaches in esophageal cancers.
Disclosure Statement: e authors declare no conict of interest.
Novel Therapeutics: Targeted Therapies,
Immunotherapies, Cellular Therapies
1060
Idecabtagene Vicleucel (ide-cel) versus Standard (std)
Regimens in Patients (pts) with Triple-class–Exposed (TCE)
Relapsed and Refractory Multiple Myeloma (RRMM): Updated
Analysis from KarMMa-3
Christoph Scheid1; Paula Rodríguez-Otero2; Sikander Ailawadhi3;
BertrandArnulf4; Krina Patel5; Michele Cavo6; Ajay K. Nooka7;
SalomonManier8; Natalie Callander9; Luciano J. Costa10; Ravi Vij11;
NizarJBahlis12; Philippe Moreau13; Scott R. Solomon14;
IngeridWeumAbrahamsen15; Rachid Baz16; Annemiek Broijl17;
ChristineChen18; Sundar Jagannath19; Noopur Raje20; Michel Delforge21;
Reuben Benjamin22; Thomas Pabst23; Shinsuke Iida24; Jesús Berdeja25;
Anna Truppel-Hartmann26; Rashmi Bhatnagar27; Fan Wu28;
JuliaPiasecki28; Laurie Eliason28; Devender Dhanda28; Jasper Felten28;
Andrea Caia28; Mark Cook29; Mihaela Popa Mckiver28; Sergio Giralt30
1University of Cologne, Cologne, Deutschland
2Clínica Universidad de Navarra, Pamplona, Spanien
3Mayo Clinic, Jacksonville, USA
4Université Paris Cité, Paris, Frankreich
5University of Texas, Houston, USA
6Bologna University School of Medicine, Bologna, Italien
7Emory University, Atlanta, USA
8Université de Lille, Lille, Frankreich
9University of Wisconsin, Madison, USA
10University of Alabama at Birmingham, Birmingham, USA
11Washington University School of Medicine in St. Louis, St. Louis, USA
12University of Calgary, Calgary, Kanada
13University Hospital of Nantes, Nantes, Frankreich
14Northside Hospital Cancer Institute, Atlanta, USA
15Oslo University Hospital, Oslo, Norwegen
16Mott Cancer Center, Tampa, USA
17Erasmus MC Cancer Institute, Rotterdam, Niederlande
18Princess Margaret Hospital, Toronto, Kanada
19Mount Sinai Medical Center, New York, USA
20Massachusetts General Hospital, Boston, USA
21Universitaire Ziekenhuizen Leuven, Leuven, Belgien
22Kings College Hospital, London, United Kingdom
23Bern University Hospital, Bern, Schweiz
24Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
25Sarah Cannon Research Institute, Nashville, USA
262seventy bio, Cambridge, USA
27Syneos Health, Haryana, Indien
28Bristol Myers Squibb, Princeton, USA
29Bristol Myers Squibb, Boudry, Schweiz
30Memorial Sloan Kettering Cancer Center, New York, USA
Background: Interim analysis of the phase 3 KarMMa-3 trial
(NCT03651128) revealed consistent ide-cel benets across TCE RRMM
pts including high-risk subgroups, with safety data comparable to pre-
vious studies. Results of the nal progression-free survival (PFS) and
interim OS analysis with longer follow-up are reported.
Methods: RRMM pts who received 2–4 prior regimens, including an
immunomodulatory agent, proteasome inhibitor and daratumumab, and
were refractory to last regimen were randomized 2:1 to ide-cel or a std
regimen. Primary endpoint was IRC-assessed PFS in the ITT population.
Key secondary endpoints were IRC-assessed overall response rate (ORR)
and overall survival (OS).
Results: Baseline characteristics of 386 randomized pts (ide-cel, n = 254;
std regimens, n = 132) were balanced. Median follow-up from randomiza-
tion to data cuto was 30.9 mo (12.7–47.8). Ide-cel signicantly improved
median PFS (95% CI) vs std regimens (13.8 [11.8–16.1] vs 4.4 [3.4–5.8]
mo), representing a 51% reduced risk of PD or death; in pts. treated with
ide-cel (n = 225) or std regimen (n = 126), median PFS (95% CI) was
15.7 (12.5–18.9) vs 4.4 (3.4–5.8) mo. Ide-cel signicantly improved ORR
vs std regimens (71% vs 42%) with deeper (CRR 44% vs 5%) and more
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts248
durable responses (median DOR 16.6 vs 9.7 mo). In the treated popula-
tion, grade (gr) 3/4 infections occurred in 27% pts in the ide-cel vs 20%
in the std regimens arm. In the ide-cel safety population, any gr cytokine
release syndrome occurred in 88% pts (gr ≥ 3 in 5%), and neurotoxicity in
15% (gr ≥ 3 in 3%). Pt-reported outcomes revealed clinically meaningful
improvements.
Discussion: is nal PFS analysis of KarMMa-3 demonstrated a sig-
nicantly longer PFS and a 51% risk reduction of PD or death with ide-
cel; responses were deeper and more durable vs std regimens. e safety
prole was consistent with previous reports, and no parkinsonism or
Guillain–Barré syndrome was reported.
Conclusion: ese data continue to support use of ide-cel in TCE RRMM
pts with 2-4 prior lines of therapy. © American Society of Hematology
(2023). Reused with permission.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
969
Novel YAP1/TAZ pathway inhibitors identied through
phenotypic screening with potent anti-tumor activity via
blockade of GGTase-I / Rho-GTPase signaling
Martin Lange1,2
1Nuvisan ICB GmbH, Berlin, Deutschland
2Bayer Pharma AG, Berlin, Deutschland
Background: is study describes the identication and target deconvo-
lution of novel small molecule inhibitors of oncogenic YAP1/TAZ activity
with anti-tumor activity in vivo. YAP1/TAZ have been shown to be aber-
rantly activated oncogenes in human tumors, resulting in enhanced cell
proliferation, metastasis and provision of a pro-tumorigenic microenvi-
ronment, making YAP1/TAZ targets for novel cancer therapies.
Methods: A high-throughput screen (HTS) of 3.8 million compounds
was conducted using a cellular YAP1/TAZ reporter assay. HTS hits that
selectively inhibited TEAD-luciferase, but not TK-Renilla-luciferase were
subsequently assessed regarding their ability to induce translocation of
YAP1 from the nucleus to the cytoplasm in MDA-MB-231 cells. Out of
these, a subset of hits showed activity to induce translocation of YAP1.
Finally, selected hits active in both assays were assessed regarding their
eect on endogenous YAP1/TAZ target genes.
Result: e small molecule BAY-856 demonstrated the most consistent
YAP1/TAZ inhibitory activity of all selected hits, which warranted fur-
ther exploration of the unknown direct drug target. Target deconvolution
studies identied the geranylgeranyltransferase I (GGTase I) complex,
as the direct target of YAP1/TAZ pathway inhibitor BAY-856. BAY-856
blocked the activation of Rho-GTPases, leading to subsequent inactiva-
tion of YAP1/TAZ and inhibition of cancer cell proliferation in several
tumor types in vitro. Multi-parameter optimization resulted in BAY-593,
an in vivo probe with favorable PK properties. BAY-593 demonstrated
anti-tumor activity in solid tumor models and blockade of YAP1/TAZ
signaling in vivo.
Discussion: We show that phenotypic screening is a viable strategy to
identify novel small molecules when combined with a matching target
deconvolution strategy.
Conclusion: Our lead molecule BAY-593 is a novel tool compound to
explore Rho-GTPase signaling and downstream YAP1/TAZ biology in
vitro and in vivo.
Indication of source:
1 is study was funded by Bayer Pharma AG
Disclosure Statement: e authors declare the following: is study was funded
by Bayer Pharma AG
Onkologische Pege
973
Analyse der speziellen pegerischen Versorgungssituation
von Adolescents und young Adults im Rahmen einer
onkologischen Erkrankung
Melisa Dietrich1
1Universitätsklinikum Essen, Essen, Deutschland
Background: Adolescents and young Adults (AYA) mit einer onkol-
ogischen Erkrankung sind eine besondere Patient*innengruppe mit
speziellen Bedürfnissen. Diese sind bedingt durch die normativen phy-
sischen als auch psychosozialen Entwicklungsschritten, welche durch das
Aureten einer onkologischen Erkrankung und den damit einhergehen-
den Komplikationen eingeschränkt werden.
Methods: Als Methodik wurde eine Literaturrecherche im Rahmen der
Erstellung einer Bachelorabschlussarbeit (B.Sc.) gewählt. Es wurde mit
den MESH Terms „AYA, „Adolescents and young adults, gepaart mit den
Begrien „cancer“, „oncology“ oder „needs“ oder „nurse“ und „nursing“
gesucht. Hierzu wurden die Datenbanken PubMed und CINAHL genutzt.
Result: AYAs mit einer onkologischen Erkrankung haben altersentspre-
chende und entwicklungsabhängige Bedürfnisse, welche nicht adäquat
in der klinischen Praxis wahrgenommen werden. Sie fühlen sich nicht
ausreichend in Entscheidungsprozesse ihrer erapie eingebunden.
Außerdem ndet Aulärung und Beratung durch das multiprofessionelle
Behandlungsteam nicht bedarfsdeckend statt. Dies inkludiert emen wie
Sexualität, Fertilitätserhalt, Survivorship und Nachsorge. Zusätzlich emp-
nden AYAs ein ausgeprägtes Bedürfnis nach Kontakt zu Gleichaltrigen
in einer ähnlichen Lebenssituation (peers).
Discussion: Es wurde festgestellt, dass AYAs, im Vergleich zur jün-
geren und älteren Patientenkohorten, weniger als einzigartige
Patient*innengruppe wahrgenommen werden und deshalb weniger über
ihre speziellen Bedürfnisse bekannt ist. Es besteht ein ausgeprägter Bedarf
an Informationsmaterialien und Beratungskonzepten speziell für AYAs.
Die Behandlungsteams sollten im Umgang und Kommunikation mit
AYAs gezielt geschult werden.
Conclusion: AYAs haben spezielle Bedürfnisse, die aber nicht bei allen
Behandelnden bekannt sind und kommuniziert werden. Es gibt Bedarfe
zur Optimierung der Versorgungsstrukturen um unter anderem eine ver-
besserte Informationsweitergabe für die Patient*innen.
Disclosure Statement: e authors declare no conict of interest.
1019
"Da fehlt einfach jemand der das Ganze koordiniert
zwischen der OP und der anschließenden Chemotherapie"
Tätigkeitsfeld einer Advanced Practice Nurse in der
Neuroonkologie
Lea Kaumann1; Regina Schmeer1
1Medizinische Hochschule Hannover, Hannover, Deutschland
Background: Das Belastungserleben von Patient:innen mit neuroonkol-
ogischen Erkrankungen sowie deren An- und Zugehörige ist sehr hoch.
Im Zentrum der Fragestellungen steht omals wie mit der Erkrankung
im Alltag umgegangen werden kann insbesondere vor dem Hintergrund
schlechter Prognosen und begrenzter Behandlungsmöglichkeiten.
Methods: Die MHH implementierte im Januar 2017 eine Advanced
Practice Nurse (APN) auf einer neurochirurgischen Station um die
Versorgungslücke der neuroonkologischen Patient:innen zu schließen.
Die Beratungs- und Versorgungsbedarfe wurden in leitfadengestützten
Interviews und einer standardisierten Befragung erhoben. Die implemen-
tierten Maßnahmen wurden anschließend evaluiert.
Result: In den leitfadengestützten Interviews wurde deutlich, dass die
Patient:innen aufgrund der neuen Situation viel Beratung und Anleitung
zur Krankheitsbewältigung benötigen. Insbesondere wenn es sich um einen
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 249
malignen Tumor mit einer weiterführenden erapie handelt und eine neu
aufgetretene Pegebedürigkeit hinzukommt. Versorgungsdezite wurden
in der Struktur der Beratung und Anleitung sowie im Einbezug der An- und
Zughörigen wahrgenommen. Besonders der Entlassungsprozess wurde als
unstrukturiert erlebt. Daher wurden eine aufsuchende Pegeberatung, eine
strukturierte Entlassungsplanung und interdisziplinäre Fallbesprechungen
als Tätigkeiten der APN implementiert.
Discussion: Die Evaluation zeigte, dass die implementierten Maßnahmen
der APN von den Patient:innen gut angenommen wird. Die aufsuchende
Pegeberatung sowie die strukturierte Entlassungsplanung werden als
sehr hilfreich erlebt und führen zu einer größeren Handlungssicherheit.
Conclusion: Die Erhebung zeigt, dass sich Patientenoutcomes durch den
Einsatz einer Advanced Practice Nurse verbessern.
Disclosure Statement: e authors declare no conict of interest.
Other Topics
1005
Current reporting practice of sex and gender in cancer clinical
trials with a patient-reported outcome endpoint: a systematic
review
Daniela Krepper1; Anna Thurner1; Lisa Wintner1; Monika Sztankay1
1University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy,
Psychosomatics, and Medical Psychology, Medical University Innsbruck,
Innsbruck, Österreich
Background: Sex and gender are acknowledged as pivotal variables in
clinical research. However, the dierences between both concepts are
oen overlooked in medical research resulting in limited generalizabil-
ity of ndings and potential bias. is review portrays current reporting
of sex and/or gender in cancer clinical trials including a patient-reported
outcome endpoint, with an emphasis on linguistic precision.
Methods: Pubmed was searched to identify randomized controlled trials
in patients with bladder, colorectal, and lung cancer, published between
2019 and February 2022. A double-review procedure was applied via
DistillerSR. e data extraction form included information on the
terms used to describe sex and/or gender. e Sex and Gender Equity in
Research (SAGER) Guidelines Checklist was applied for quality appraisal.
Result: e Pubmed search resulted in 2450 identied records, of which
184 proved to be eligible. e term sex was used in 54.9%, gender in
21.2%, and both terms in 17.4% of the trials, while 6.5% reported none.
39.1% of trials used the terms sex and/or gender appropriately (i.e. refer-
ring to biological or social categories) and consistently. 60.9% of trials
combined the terms in varying ways, which was not due to reporting of
both concepts, but rather to synonymous use. In terms of compliance with
the SAGER Guidelines Checklist, the median number of items meeting
the requirements was 2 out of 17.
Discussion: Our review shows that most trials lack linguistic precision
in reporting sex and/or gender, portraying the educational need for these
dierent concepts in the eld of clinical trials with PRO endpoints. e
synonymous use of the terms sex and gender does not do justice to their
dierent conceptualizations and might only contribute to further confu-
sion instead of promoting the imperative inclusion of these biological and
social concepts in medical research.
Conclusion: Raising awareness and compliance with existing SAGER
guidelines in cancer clinical trials would enhance the credibility of con-
clusions drawn regarding sex and/or gender dierences.
Disclosure Statement: e authors declare no conict of interest.
1112
Realization of a virtual multidisciplinary tumor board:
Asolution for the future?
Matthias Zipp1; Sandra Gottschling2; Christoph Schäfer1;
Hans-Ulrich Braner3; Kia Homayounfar2
1Gesundheit Nordhessen Holding AG, Kassel, Deutschland
2Klinikum Kassel, Kassel, Deutschland
3Kreisklinik Hofgeismar, Hofgeismar, Deutschland
Background: Multidisciplinary Tumor Boards (MTB) represent the
gold-standard of decision making in oncology. However, increasing ther-
apeutic options and quality requirements challenge the manpower and
nancial resources for conducting MTB. Digital solutions like virtual
MTB (vMTB) may provide a time saving and cost-ecient alternative
especially for participants from dierent sites. However, in the EU and in
Germany, data protection requirements are high. General Data Protection
Regulation (GDPR) compliance severely restricts the choice of possible
systems.
Methods: For optimal interaction of participants, a two-way transmission
of image and sound is required. is was met by Zoom Rooms. e sys-
tem was initially installed on a PC and later transferred to a neat.bar pro
appliance for easier handling. Finally, it shows all participants, imaging
of the patient and Hospital Information System (HIS) on three screens.
Result: We have been holding a weekly vMTB for four months. e par-
ticipants were trained and needed little support at the beginning. We
currently have one permanent participating hospital. e high quality of
image and sound enables face-to-face-like discussion. e special chal-
lenge is end-to-end-encryption (E2EE) under control of the leading hos-
pital and its ease of use at the same time.
Discussion: e vMTB consists of both, the digital transfer of patient
data from dierent sites into the HIS and the actual virtual conference.
While we established a well-functioning GDPR-approved conference sys-
tem with high acceptance along with only a Zoom client installation at
participating sites, the digital data transfer process is still demanding due
to the lack of interfaces to the HIS and uncertainty with regard to data
protection at external sites.
Conclusion: e vMTB oers substantial advantages compared to MTB,
especially for the participants at external sites. GDPR compliance must
be ensured any time. We are planning to expand to further sites as well as
dierent entities next year.
Disclosure Statement: e authors declare no conict of interest.
1011
Establishing thresholds for clinical importance for disease-
specic EORTC questionnaire modules
Anna Thurner1; Micha Pilz1; Juan I. Arraras2; Renee Bultijnck3; Kelly de Ligt4;
Fabio Ecace5; Tihana Gašpert6,7; Mogens Groenvold8; Bernhard Holzner1;
Jörg Andreas Müller9; Katarzyna Pogoda10; John Ramage11;
HeikeSchmidt9; Teresa Young12; Johannes Giesinger1
1University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy,
Psychosomatics, and Medical Psychology, Innsbruck Medical University,
Innsbruck, Österreich
2Hospital of Navarre, Pamplona, Spanien
3Ghent University Hospital, Ghent, Belgien
4Department of Psychosocial research and Epidemiology, Amsterdam, Niederlande
5Italien Group for Adult Hematologic Diseases (GIMEMA) Data Center, Rome, Italien
6Nursing Home Mali Kartec, Krk, Kroatien
7Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
8University of Copenhagen, Copenhagen, Dänemark
9University Hospital Halle (Saale), Halle (Saale), Deutschland
10Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Polen
11Hampshire Hospitals NHS Foundation Trust, Basingstoke, United Kingdom
12Mount Vernon Cancer Centre, Northwood, United Kingdom
Background: e patient-reported outcome (PRO) measures developed
by the European Organisation for Research and Treatment of Cancer
(EORTC) Quality of Life Group are the most widely used questionnaires
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts250
for assessing the patients’ perspective on cancer and cancer treatment.
To facilitate PRO interpretation, our study aims to establish threshold
scores for clinical importance (TCIs) for eight disease/population-spe-
cic EORTC questionnaire modules that target the most prevalent cancer
types in Europe.
Methods: For this prospective study we are recruiting 225 cancer patients
at ten European centres for each of the following eight groups: elderly
patients and patients with breast, prostate, colorectal, endometrium, lung,
head and neck, and ovarian cancer. Patients participating in the study
completed the respective EORTC module and answered anchor questions
on predened aspects of clinical importance (emotional burden, limita-
tions of daily life, and need for help) related to each of the assessed health
domains.
Results: At the time of abstract submission, we have recruited 370 cancer
patients, and initial results are already available for the EORTC module
for elderly cancer patients. ese results indicate that the EORTC mod-
ules provide high diagnostic accuracy for the identication of clinically
important health issues with an area under the curve and sensitivity for
selected thresholds above 0.80 for the assessed health domains. Latest
study results will be presented at the conference.
Discussion: e initial results align with the previous study on TCIs for
the EORTC QLQ-C30 cancer questionnaire (Giesinger et al., 2020, J Clin
Epidemiology) that also demonstrated high diagnostic accuracy for iden-
tication of clinically important health issues.
Conclusion: In conclusion, the results from our study will facilitate the
interpretation of PRO scores obtained via the EORTC questionnaires. e
TCIs may support symptom screening and monitoring in daily clinical
practice, and be used for responder denition in clinical trials.
Disclosure Statement: e authors declare no conict of interest.
Primary and Secondary Prevention
1063
UCan: Unveiling the Power of Prevention – Insights from
aBaseline Analysis
Antonia von Ellerts1; Ulrike Haidn1; Theres Fey1; Sebastian Theurich2;
Enrico N. De Toni3; Volker Heinemann1,4; Nicole Erickson1
1Comprehensive Cancer Center (CCC Munich LMU), Ludwig Maximilian
University (LMU) Hospital Munich, München, Deutschland
2Department of Medicine III, Ludwig Maximilian University (LMU) Hospital
Munich, München, Deutschland
3Department of Medicine II, Ludwig Maximilian University (LMU) Hospital
Munich, München, Deutschland
4Comprehensive Cancer Center Munich (CCC Munich), München, Deutschland
Background: Cancer prevention through lifestyle modication has been
identied as a priority in Europes Beating Cancer Plan and is detailed in
the European Code Against Cancer (ECAC) (1). 30-50% of cancer cases
could potentially be prevented through lifestyle changes (2). As role mod-
els, healthcare professionals and medical students must recognize the pre-
ventive potential of the ECAC and actively practice what they advocate.
Methods: A baseline awareness survey was conducted among hospital
sta and medical students (Sept 23 - Dec 23). Based on Perula-de Torres
et al. (2021) (3), we hypothesized that 50% of the population will name
≥6/12 points from the ECAC correctly.
Result: 2964 subjects participated. At least half of the study population
is not aware of ≥2 points of the ECAC recommendations and a third of
the subjects named ≥2 points that were not backed by adequate evidence.
Only 64% report regularly undergoing screening measures. 50% failed to
acknowledge the cancer preventative potential of immunizations. Only
16% consume the recommended portions of vegetables (≥3) and 30%
consume ≥2 portions of fruit. 30% fell below the recommended physical
activity guidelines.
Discussion: While many demonstrate basic health knowledge, concern-
ing disparities remain between awareness and practice. is highlights
the need for interventions to close this gap and encourage lasting change,
especially among healthcare professionals.
Conclusions: Essential information gaps exist regarding the ECAC
knowledge and implementation. Results will inform content development
for a pre and post intervention study design evaluating ECAC awareness
and behaviour changes.
Indication of source:
1. IARC. (2016). European Code Against Cancer. WHO. https://cancer-code-
europe.iarc.fr/index.php/en/ (14.12.23)
2. WHO. (2023). Preventing cancer. https://www.who.int/activities/preventing-
cancer (14.12.23)
3. Perula-de Torres et al. (2021). Awareness of the European Code Against Cancer
of Family Medicine Residents and Nursing and Medicine Students in Spain. J
Cancer Educ, 36(5), 1069-1074.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
979
The establishment of a German Reference Network for
Hereditary Tumor Syndromes to implement the European
Reference Network achievements into a national health care
system
Stefan Aretz1,2,3; Nadine Weinstock4; Christian Kratz5; Alexander Volk3,6;
Isabel Spier1,2,3; Miriam Elbracht7; Christian Sutter8; ChristopherSchroeder9;
Reiner Siebert10; Nicola Reents11; André Reis3,12,13; Evelin Schröck3,14,15;
LorenzGrigull4; Tim Ripperger3,16; VerenaSteinke-Lange3,17,18;
ElkeHolinski-Feder3,17,18
1Institute of Human Genetics, Medical Faculty, University of Bonn, Bonn,
Deutschland
2Center for Hereditary Tumor Syndromes, University Hospital Bonn, Bonn,
Deutschland
3European Reference Network on Genetic Tumour Risk Syndromes (ERN
GENTURIS), Nijmegen, Niederlande
4Centre for Rare Diseases, University Hospital Bonn, Bonn, Deutschland
5Pediatric Hematology and Oncology, Hannover Medical School, Hannover,
Deutschland
6Institute of Human Genetics, University Medical Center Hamburg-Eppendorf,
Hamburg, Deutschland
7Institute for Human Genetics and Genomic Medicine, Medical Faculty, RWTH
Aachen University, Aachen, Deutschland
8Institute of Human Genetics, University Hospital Heidelberg, Heidelberg,
Deutschland
9Institute of Medical Genetics and Applied Genomics, University Hospital
Tübingen, Tübingen, Deutschland
10Institute of Human Genetics, Ulm University and Ulm University Medical
Center, Ulm, Deutschland
11SemiColon – Lynch-Syndrome Patient Network, Mönchengladbach,
Deutschland
12Institute of Human Genetics, University Hospital Erlangen, Friedrich-Alexander
Universität Erlangen-Nürnberg, Erlangen, Deutschland
13Centre for Rare Disorders Erlangen (ZSEER), University Hospital Erlangen,
Erlangen, Deutschland
14Translational Medical Oncology, Faculty of Medicine and University Hospital
Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
15Institute for Clinical Genetics, University Hospital Carl Gustav Carus,
Technische Universität Dresden and Hereditary Cancer Syndrome Center
Dresden, Dresden, Deutschland
16Department of Human Genetics, Hannover Medical School, Hannover,
Deutschland
17MGZ - Medical Genetics Center, München, Deutschland
18Arbeitsgruppe erbliche gastrointestinale Tumore, Medizinische Klinik und
Poliklinik IV – Campus Innenstadt, Klinikum der Universität München, München,
Deutschland
Background: e foundation of European Reference Networks (ERN)
represents a major step to improve patient care and research for 24
rare and complex disease groups. As a whole, families with Hereditary
Tumor Syndromes (HTS) are a relevant target group and a paradigm for
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 251
successful preventive and precision oncology. However, it is suspected
that the majority of patients is still not diagnosed or experience a substan-
tial delay in diagnosis, which results in inadequate medical care. e ERN
GENTURIS aims to improve and standardize identication, genetic diag-
nostics, personalized prevention, and treatment of families with GENetic
TUmour RIsk Syndromes across Europe. So far, several specic guide-
lines, educational activities, and research projects have been developed.
Nevertheless, these achievements will only improve oncological care, if
they are implemented in national health care systems, which is regarded as
a major shortcoming also addressed by the EU JARDIN initiative.
Methods: erefore and in line with the EU requirements, a German
Reference Network for Hereditary Tumor Syndromes (GRN HTS) was
established in 2023 as one of 12 GRNs to date (www.se-atlas.de/drn).
Result: Currently, the GRN HTS consists of 11 centers, which are ERN
members and / or specialized B centers of Centers for Rare Diseases (A
centers). Overall, the network oers expertise for a broad spectrum of rare
HTS and involves patient representatives. e website is intended to act as
an information platform for all relevant areas and sources regarding clin-
ical and research aspects of HTS and is planned to go online in January
2024.
Discussion: Challenges are the recruitment of expert clinicians for specic
areas to complement the existing composition including the improvement
and extension of specialized outpatient clinics.
Disclosure Statement: e authors declare no conict of interest.
Conclusion: Future goals of the network include the implementation of registries
for rare HTS, training programs for organ-specic cancer centers, cross linking
with other initiatives in the eld, and ensuring the interoperability between local
and ERN data structures.
1122
PREVENT-TAKE-UP - individuelle Gesundheitskompetenz
stärken und fördern
Angelika Kestler1; Julian Schwab2; Yvonne Schmid1; Tanja Jaehnig3;
Michael Melzer4; Friedemann Zengerling4; Christian Bolenz4;
Stefan Lukac5; Wolfgang Janni5; Anne Barzel3; Hans Armin Kestler6;
Thomas Seuerlein1
1Universitätsklinikum Ulm, Klinik für Innere Medizin I, Ulm, Deutschland
2Universität UIm, Institut für medizinische Systembiologie, Ulm, Deutschland
3Universitätsklinikum Ulm, Institut für Allgemeinmedizin, Ulm, Deutschland
4Universitätsklinikum Ulm, Klinik für Urologie, Ulm, Deutschland
5Universitätsklinikum Ulm, Klinik für Frauenheilkunde, Ulm, Deutschland
6Universität UIm, Institut für medizinische Systembiologie, Ulm, Deutschland
Die Präventions- und Früherkennungs-App PREVENT-TAKE-UP soll
die Eigenverantwortlichkeit und individuelle Gesundheitskompetenz
von Patientinnen und Patienten stärken und einen Beitrag zur Förderung
der öentlichen Gesundheit leisten. Zielgruppe sind gesunde Personen,
die noch nicht an Vorsorgeuntersuchungen zu Brust-, Darm- oder
Prostatakrebs teilgenommen haben. Die App vermittelt Informationen
individualisiert an die Bedarfe und Bedürfnisse der Nutzer:innen vermit-
teln und eine informierte Entscheidungsndung unterstützen. Ziel ist die
Motivation zur Teilnahme an Vorsorge- und Früherkennungsmaßnahmen,
unter Berücksichtigung des eigenen Risikos, zu erhöhen und somit
Tumorerkrankungen in einem früheren Stadium mit höherer Aussicht
auf Heilung festzustellen.
Die App wurde multidisziplinär vom Institut für Medizinische
Systembiologie an der Universität Ulm in enger Kooperation mit
der Gastroenterologie, Gynäkologie, Urologie und dem Institut für
Allgemeinmedizin entwickelt.
In einer ersten Anwendungsstudie wurde die App von Patient:innen
in allgemeinmedizinischen Facharztpraxen getestet. Die Handhabung
wurde als einfach, die Fragen, wie auch die Informationen als relevant und
verständlich bewertet. Eine deutliche Mehrheit der Probanden würde das
durch die App empfohlene Arztgespräch nutzen. Männer sind dabei eher
häuger als Frauen unentschlossen, insgesamt zeigte sich die gemeinsame
Tendenz, dass die App motiviert, mehr an Vorsorge zu denken. Förderlich
hierfür sind die niederschwellige Verfügbarkeit (ohne Passwort/Account)
und die Anonymität, was zu einer breiten Nutzung und wahrheits-
gemäßen Beantwortung der Fragen führt und ggf. Hemmschwellen im
Vergleich zu einem persönlichen Erstgespräch mit dem Arzt/ der Ärztin
senkt.
Disclosure Statement: e authors declare no conict of interest.
990
An interactive cancer prevention awareness program for
adolescents provided by interdisciplinary experts from the
Comprehensive Cancer Center Munich
Irina Rupp1; Julian Holch1,2; Theres Fey1,10; Friederike Mumm2,3;
ClaudiaMück3; Anika Berling-Ernst4; Sabine Kesting5,6; Carolin Margraf7;
Christine Welker8; Hansjörg Baurecht8; Volker Heinemann1,9,10;
NicoleErickson1
1Comprehensive Cancer Center (CCC Munich LMU), Ludwig Maximilian
University (LMU) Hospital Munich, München, Deutschland
2Department of Medicine III, Ludwig Maximilian University (LMU) Hospital
Munich, München, Deutschland
3Interdisciplinary Center of Psycho-Oncology, Ludwig Maximilian University
(LMU) Hospital Munich, München, Deutschland
4Department I Internal Medicine, Center of Integrated Oncology, University
Hospital of Cologne, Köln, Deutschland
5Department Health and Sport Sciences, TUM School of Medicine and Health,
München, Deutschland
6Department Clinical Medicine, TUM School of Medicine and Health, München,
Deutschland
7Comprehensive Cancer Center München (CCC TUM), University Hospital rechts
der Isar, Technical University Munich, München, Deutschland
8Department of Epidemiology and Preventive Medicine, University of
Regensburg, Regensburg, Deutschland
9Comprehensive Cancer Center Munich (CCC Munich), München, Deutschland
10Bavarian Cancer Research Center (BZKF), Ludwig Maximilian University (LMU)
Hospital Munich, München, Deutschland
Background: Cancer prevention is a major goal of public health agencies
worldwide1. Information provision followed by behavior change advice
can increase the likelihood of habitual behavior2. erefore, we aimed to
increase awareness of the European Code Against Cancer (ECAC)3 and
promote lifestyle habit initiation among a representative sample of adoles-
cents in Bavaria, Germany.
Methods: is ongoing prospective interventional study comprises of
digitally based workshops, enhanced with a variety of active learning
components and culminating in a live interdisciplinary expert round.
ECAC awareness is assessed on hand questionnaires pre and post inter-
vention and again aer 3 months. Additionally, health behavior change is
measured using the transtheoretical model of change.
Results: In 2023, 8 schools from 4 dierent Bavarian districts completed
the workshop. To date, n = 645 adolescents from 3 dierent tiers of the
education system participated. 315 follow-up questionnaires have been
completed. 73 % specied that they found the information useful and 69 %
stated that the workshop provided practical implementation suggestions.
Discussion: Digitally based workshops enable experts to reach a wider
and more varied population. e participants demonstrate an initial
increased awareness of the ECAC and indicate that the program provides
practical implementation strategies.
Conclusion: Interactive health literacy studies focusing on cancer pre-
vention awareness are well received and a feasible method of increasing
awareness and implementation of the ECAC.
is study is funded by: Bavarian State Ministry of Health and Care
Indication of source:
1 World Health Organization (2023). Preventing cancer. https://www.who.int/
activities/preventing-cancer (14.12.2023)
2 Gardner, B., et. al. (2012). Making health habitual: the psychology of ‘habit-
formation’ and general practice. Br J Gen Practc, 62(605), 664–666.
3 International Agency For Research On Cancer (2016). European Code Against
Cancer. https://cancer-code-europe.iarc.fr/index.php/de/ (14.12.2023)
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts252
Psychooncology
1008
Screening in psycho-oncology – systematic assessment of the
psychosocial care needs of oncological and hematological
pateints in the outpatient setting
Michelle Entlicher1
1Landeskrankenhaus Feldkirch, Feldkirch, Österreich
Background: e diagnosis of cancer is oen accompanied by physical,
psychological and social problems. is does not only aect the qual-
ity of life of patients, but also their physical health and overall survival.
Adequate, needs-oriented psychosocial care contributes to the reduc-
tion of psychological distress in cancer patients and their relatives and
improves the quality of life. e aim of this study is to assess the need
and the utilization of psychosocial care of oncological and hematological
patients in an outpatient setting.
Methods: In a sample of 270 cancer outpatients (52.6% female), the
Distress ermometer, the GAD-7 and the PHQ-9 are used to assess rates
of distress, anxiety and depression. Furthermore the number of patients
who would utilize psychosocial support services were collected. Applying
the average marginal eect of the logit regression, the prevalence of the
utilizaiton of psychosocial support services was compared.
Result: One h of the sample would like an appointment with psycho-
social support services regarding psychological support. In contrast, only
around 7% of respondents wanted support in relation to care and nursing
or social work. e majority of these patients wanted a referral from the
hospital to the external psychosocial support service.
Discussion: According to the results of the analysis, dierent predictors
lead to the utilization of psychosocial support services in dierent cate-
gories. e desire for a support oer in one category is related to a desire
for support in another oered category. Further ndings indicate the rele-
vance of worries and nervousness, which have a positive inuence on the
use of psychosocial support services.
Conclusion: Patients suering from severe anxiety and symptoms
of depression were already linked to psychosocial support services.
Nevertheless, the ndings emphasize the importance of routine screening
techniques to evaluate psychosocial distress, as well as continued explo-
ration of the reasons for the need of support services for cancer patients.
Disclosure Statement: e authors declare no conict of interest.
1146
Potential and limitations of an inpatient therapeutic concept
for cancer patients with mental illnesses
Katja Schreyer1; Theresa Grimm1; Kristin Härtl2; Birgitt Marten-Mittag3;
Sabine Schäfer1
1Klinik Bad Trissl, Oberaudorf, Deutschland
2Fresenius Hochschule, München, Deutschland
3TUM, München, Deutschland
Background: Patients diagnosed with severe mental disorders linked to
their cancer diagnosis oen receive insucient psychotherapeutic sup-
port which can lead to an exarcerbation of psychological symptoms. Also,
a guideline-recommended cancer therapy can be impeded because of
psychological co-morbidities since simultaneous therapies oen prove to
be dicult. Due to this gap in healthcare provision a stationary therapy
program was developed and it‘s eectiveness evaluated within a long-term
study.
Methods: During the 6- to 12-weeks therapy program, patients partic-
ipated in multiprofessional therapies and, if needed, simultaneously
received their acute cancer therapy. e psychological and physical state
of the patients (n=144) was assessed by self-assessment questionnaires
(HADS-D, FBK-R23, EORTC-FA12 and others) at four measurment dates
(T1=start, T2=end, T3=3-months follow-up, T4=1-year follow-up).
Result: 91% of the patients had an aective disorder as their main diag-
nosis, 56% were diagnosed with gynecological cancer. 59% of patients
received cancer treatment. In the statistical comparisons a highly signicant
reduction in depression, anxiety, psychosocial stress experience and fatigue
symptoms was observed between T1 and T3 (all: p<0.001). e evaluation
of the T4-sample (response rate 57%) is in further analysis due to confound-
ing factors. Looking at referrers it becomes apparent that 74% of patients
were sent by psycho-oncologically trained sta, 17 % by physicians.
Discussion: e inpatient treatment leads to signicant improvement in
depression, anxiety, psychosocial stress and fatigue symptoms from the
start until 3 months aer discharge. Diculties arose in the evaluation of
the 1-year-follow-up.
Conclusion: It can be assumed, that the program can ll a gap in the
healthcare landscape. A future aim is to increase awareness of medical sta
and pay particular attention to patients with severe psychiatric disorders.
Disclosure Statement: e authors declare no conict of interest.
1009
Psychosocial aftercare needs of breast cancer patients in
Vorarlberg/Austria
Angelika Brüstle-Wild1
1Landeskrankenhaus Feldkirch, Feldkirch, Österreich
Background: e diagnosis of cancer can be described as a complex,
lengthy disease with numerous side eects. In addition, there are phys-
ical changes and psychological stress for patients and their social envi-
ronment. New treatment methods increase the risk of chronic diseases.
In 2020, 1 971 new invasive cases and 17 000 chronically ill people were
registered in Vorarlberg. is study examines the need for psychosocial
follow-up care for breast cancer patients aer acute care in the Feldkirch
speciality hospital, especially in the context of the current psycho-onco-
logical care situation in Vorarlberg. e need is examined empirically
using standardized questionnaires, primarily for breast cancer patients.
Methods: In semi-structured telephone interviews, sociodemographic
characteristics and quantitative data are collected. Established screening
instruments, such as FBK-R10 (Herschbach & Weis, 2010) and NCCN
Distress-ermometer (Mehnert et al., 2006) will be utilised and a partial
survey of patients, whose diagnosis was made in the years 2020 to 2022 in
the main hospital in Feldkirch will be carried out.
Result: e study, with 85 female subjects with an average age of 58 years,
identied clinically meaningful values on the Distress-ermometer Scale
and the problem list. More than a third of patients exceeded these values
on a physical and emotional level. e Spearman correlation revealed a
signicant positive association between the time since diagnosis and the
number of Distress-ermometer problems.
Discussion: ese ndings indicate that the psycho-oncological care sit-
uation in Vorarlberg should be strengthened and adapted to the specic
needs of patients, especially aer acute care, in order to improve the qual-
ity of life and well-being of oncological patients.
Conclusion: e results underline the need for improved information
transfer and optimized aercare, especially with regard to rehabilitation,
treatment options, psycho-oncological support and sensitive doctor-pa-
tient communication.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 253
Radiation
1084
Outcome of WHO Grade 2 and 3 meningiomas after
radiotherapy based on an integrated molecular-
morphological meningioma classication
Helen X. Hou1; Claire Delbridge2; Thomas Hielscher3; Benedikt Wiestler4,5;
Chiara Negwer6; Jan Peeken1; Christian Diehl1; Kai Borm1; Sandro Krieg6,7;
Kaywan A. Afthay6; Igor Yakushev8; Bernhard Meyer6;
StephanieCombs1,9,10; Felix Sahm11; Denise Bernhardt1,9
1Department of Radiation Oncology, Klinikum rechts der Isar, Technical
University of Munich (TUM), München, Deutschland
2Department of Neuropathology and Pathology, TU Munich, School of
Medicine, München, Deutschland
3Department of Biostatistics, German Cancer Research Center (DKFZ),
Heidelberg, Deutschland
4Department of Neuroradiology, Klinikum rechts der Isar, TU Munich, München,
Deutschland
5TranslaTUM, TU Munich, München, Deutschland
6Department of Neurosurgery, Klinikum rechts der Isar, TU Munich, München,
Deutschland
7Department of Neurosurgery, University Heidelberg, Heidelberg, Deutschland
8Department of Nuclear Medicine, Klinikum rechts der Isar, TU Munich,
München, Deutschland
9Institute of Radiation Medicine (IRM), Department of Radiation Sciences (DRS),
Neuherberg, Deutschland
10Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site
Munich, München, Deutschland
11Department of Neuropathology, Institute of Pathology, Ruprecht-Karls-
University Heidelberg, Heidelberg Germany; Clinical Cooperation Unit
Neuropathology, German Cancer Research Center (DKFZ), Heidelberg,
Deutschland
Background: Meningiomas (MNGs) occur in dierent histopathological
subtypes. e WHO grading system classies a subset as grade 2 and 3,
indicating a more aggressive course. Recent advances in risk stratication
introduces an integrated molecular-morphological score (IntS), oering
improved risk prediction over the traditional WHO classication. is
study aims to evaluate the prognostic utility of IntS in the context of adju-
vant radiotherapy (RT).
Methods: is retrospective study analyzed 55 patients with histolog-
ically diagnosed WHO grade 2 and 3 MNG treated with adjuvant RT.
Molecular analyses using Illumina 450k Human BeadChip and 850k EPIC
stratied patients into 3 risk groups (low, intermediate and high) using
an integrated model (IntS) that combines WHO grading, Copy Number
Variations (CNVs), and Methylation Families (MF).
Result: Aer 5 years a local failure-free survival (LFFS) rate of 50% in
MF-malignant MNG contrasts with an LFFS rate of over 80% in MF-benign
and MF-intermediate MNG. Aer 72 months early RT showed a potential
benet in MF-intermediate MNGs with a LFFS of 75% compared to an
LFFS of 25% with late RT. Additionally, a signicant correlation between
CNVs and LFFS was observed in the adjuvant setting.
Discussion: e integration of molecular and morphological criteria into
IntS highlighted distinct 5-year LFFS disparities across dierent risk cate-
gories. A pronounced therapeutic advantage of early adjuvant RT in terms
of LFFS has been shown in patients aicted with intermediate-grade
meningiomas (MFint), underscoring the potential of early adjuvant RT
in altering disease trajectory. Despite the promising direction, the small
cohort size calls for larger-scale studies to solidify the timing and extent
of RT benets.
Conclusion: e integration of DNA-methylation and CNV-proles into
the IntS unied risk score oer an enhanced prognostic dierentiation of
MNG patients. is approach shows a promising direction for guiding
the optimal timing of adjuvant RT, oering a path toward more tailored
treatment strategies for MNGs.
Disclosure Statement: e authors declare no conict of interest.
1125
Validation of scoring systems to predict overall survival
after stereotacic body radiation therapy (SBRT) for spinal
metastases
Maria Waltenberger1,2; Christian Strick1; Marco M.E. Vogel1;
Stephanie E. Combs1,2,3
1Department of Radiation Oncology, Klinikum rechts der Isar, Technical
University of Munich (TUM), Munich, Deutschland
2German Cancer Consortium (DKTK), partner site Munich, a partnership
between DKFZ and University Hospital Klinikum rechts der Isar, Germany,
Munich, Deutschland
3Institute of Radiation Medicine (IRM), Helmholtz Zentrum, Neuherberg,
Deutschland
Background: Spinal metastases (SM) are increasingly treated with SBRT,
both in the context of oligometastatic disease (OMD) and palliation.
ere exist two scoring systems (SS) for overall survival (OS) prediction
aer spinal SBRT: Kowalchuck et al. developed a score (KS) for OMD
patients (pat) receiving brain, lung or spinal SBRT (2023; validated exter-
nally). e PRISM score assesses OS aer spinal SBRT (Tang et al., 2015;
validated internally). Further validation analyses are desirable prior to
routine use of the SS.
Methods: N=79 pat with n=96 SM received SBRT between 2010 and 2022
at our institution and were included in the validation analyses. For KS,
only OMD pat (= max. 5 metastases) were analyzed. Scores were calcu-
lated for each pat. OS was assessed with Kaplan-Meier method. e prog-
nostic relevance of the SS was tested using log-rank test.
Result: N=74 pat received SBRT for OMD and n=5 pat in palliative
intent. Most common entities were prostate (n=37) and breast (n=15)
cancer, NSCLC (n=7), melanoma (n=6), head/neck cancer and sarcoma
(n=4 each). Most pat were male (n=53), had good ECOG (n=57), bone
metastases only (n=63) and no previous local therapy (n=76). Time from
diagnosis to SM was mostly <5 years (n=52). SBRT was mainly delivered
with 5 x 5/8 Gy (n=40). Median time from SBRT to last follow up/death
(known for n=21 pat) was 22 months (m; IQR 13.5-37). Median OS was
64 m (95% CI 30.03-91.97) for all and 83 m (95% CI 48.04-121.86) for
OMD pat. For KS, pat were assigned to groups (G) 0 - 3 that showed sig-
nicant OS dierences (p=0.004). For PRISM, pat were stratied into G
1 - 4 with signicant OS dierences (p<0.001) as well.
Discussion: With a high proportion of OMD pat with good ECOG, our
cohort did not represent all G of the respective SS. e relatively low num-
ber of pat and deaths are limiting as well. Nevertheless, we were able to
externally conrm the predictive relevance of the two SS.
Conclusion: Our data support the assumption that KS and PRISM are
valid tools for OS prediction aer spinal SBRT. Conrmatory analyses in
a larger and more heterogenous cohort are warranted.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts254
1070
C-reactive protein (CRP) is the most robust laboratory value
associated with prognosis in patients with inoperable stage
III non-small cell lung cancer (NSCLC) treated with denitive
radiochemotherapy (RCT)
Cedric Richlitzki1,2; Marcel Wiesweg3,4; Martin Metzenmacher3,4;
NikaGuberina2; Thomas Gauler2; Hubertus Hautzel5,6; WilfriedEberhardt3,4;
Kaid Darwiche7; Dirk Theegarten8; Martin Schuler3,4,6; Martin Stuschke2;
Maja Guberina2,9
1Department of Radiotherapy and Radiation Oncology, University Hospital
München, LMU, München, Deutschland
2Department of Radiotherapy, West German Cancer Center, University Hospital
Essen, Essen, Deutschland
3Department of Medical Oncology, West German Cancer Center, University
Hospital Essen, Essen, Deutschland
4Division of Thoracic Oncology, University Medicine Essen – Ruhrlandklinik,
Essen, Deutschland
5Department of Nuclear Medicine, University Hospital Essen, West German
Cancer Center, University Duisburg-Essen, Essen, Deutschland
6German Cancer Consortium (DKTK), Partner Site University Hospital Essen,
Essen, Deutschland
7Department of Pulmonary Medicine, Section of Interventional Pneumology,
University Medicine Essen – Ruhrlandklinik, West German Lung Transplantation
Center, Essen, Deutschland
8Institute of Pathology, University Hospital Essen, Essen, Deutschland
9German Cancer Consortium (DKTK), Partner Site University Hospital Essen,
Essen, Deutschland
Background: Aim was to gather data on blood parameters (BP), their
prevalence, and impact on overall survival (OS). Seven BP from 160
patients were analyzed at ve time points during the therapy.
Methods: OS was dened from start of radiotherapy (RT) to death.
Kaplan Meier analyses and the Log Rank test were employed for OS anal-
yses. Cox regression analysis was utilized to examine factors inuencing
OS. BP with p < 0.05 underwent multivariate analyses with clinical cofac-
tors. Deviations from the Proportional Hazards assumption were assessed
using the Kolmogorov Type Supremum Test. Cross validation was con-
ducted to estimate predictions for similar patient populations using the
Leave One Out Cross Validation (LOOCV) method. Prognostic models
were constructed on training datasets and then applied to the omitted
dataset to classify high and low risk groups split at the median. In an iter-
ative process, models with clinical parameters (CP) were compared with
those incorporating additional BP. BP were classied as continuous vari-
ables or according to the median. Exploratory analyses were performed
with cut o values deemed relevant in prior studies.
Result: Elevated CRP value as a continuous variable (HR 1.099 (1.038 –
1.164) p=0.0012) as well as aer a data split at the median (HR 2.214
(1.388 – 3.531) p=0.0008) in the last RT week emerges as a prognostic
factor for OS. In the multivariate analysis of BP and key CP, the CRP value
remained signicant (HR 1,105 (1,040 - 1,173) p ,0012). Even aer per-
forming LOOCV of the CRP value together with CP, a p-value of 0.0177
was obtained. us, the CRP value at the end of RT has successfully passed
the critical test of cross validation.
Discussion: Elevated BP do provide inuence on clinical treatment deci-
sions regarding RCT. Among the analyzed BP, the CRP value at the end of
RT was the most robust BP associated with OS.
Conclusion: e data presented on the CRP value may show that, in the
course of therapy, inammation markers should gain importance and
attention, especially with the increasing importance of immunotherapy as
a consolidation therapy for NSCLC.
Disclosure Statement: e authors declare no conict of interest.
Rehabilitation, Sports Medicine, and
Long-term Burden in Cancer Survivors
1089
Sport as tool for symptom reduction in patients with systemic
mastocytosis - is it feasible? - Results of a multicenter
survey of the East German Study Group for Hematology and
Oncology (OSHO #97)
Theresa Koch1; Jens Panse2,3; Deborah Katharina Christen2,3;
SusannSchulze4,5; Dietrich Kämpfe6; Nicole Hegmann7;
ChristianJunghanß1; Sabine Felser1
1Department of Medicine Clinic III, Hematology, Oncology, Palliative Medicine,
University Medical Center Rostock, Rostock, Deutschland
2Department of Oncology, Hematology, Hemostaseology and Stem Cell
Transplantation, University Hospital RWTH Aachen, Aachen, Deutschland
3Center for Integrated Oncology (CIO), Aachen, Bonn, Cologne, Düsseldorf,
Deutschland
4Krukenberg Cancer Center Halle (Saale), University Hospital Halle, Halle (Saale),
Deutschland
5Department of Medicine Clinic II, Hematology, Oncology, Palliative Medicine,
Carl-von- Basedow-Klinikum, Merseburg, Deutschland
6Hematology and Oncology Practice, Lüdenscheid, Deutschland
7Mastocytosis self-help network e.V., Köln, Deutschland
Background: Systemic mastocytosis (SM) is characterized accumulation
of clonal mast cells within various organs with dierent degrees of organ
involvement +/- dysfunction. e release of mast cell mediators can lead
to a plethora of symptoms including allergic reactions and can be trig-
gered by various factors such as physical exertion. Whether sports can
help to reduce SM symptom burden - as described for other clonal (neo-
plastic) diseases - has yet not been investigated.
Methods: A multicenter SM patient (pts; ≥18 years) survey was conducted
between 03 and 12/2022 in cooperation with the Mastocytosis Self-Help
Network (DRKS 00023698). Recorded were: demographics, clinical data,
symptom burden, quality of life (QoL), triggers and fears in connection
with sports, the level of information on “physical activity in SM” and
-using the Transtheoretical Model of Behavior Change- the motivation
for regular exercise. Sporty active and inactive pts were compared.
Result: e analysis included 159 questionnaires (134 (84%) female, mean
age 51 ± 11 years). No group dierences with regard to demographic and
clinical data were observed. Sporty active pts (n = 60, 38%) showed lower
symptom burden and better QoL compared to inactive pts (n = 99, 62%;
p = 0.018). Within the sport inactive pts, light sporting activities were
signicantly more likely to trigger symptoms compared to the active pts
(30% vs. 17%), but 19% stated that sport was not a trigger and 21% were
unaware. More inactive than active pts were afraid of allergic reactions in
the context of sport (59% vs. 40%, p = 0.026). Overall, 66% of pts stated
that they were insuciently informed about the topic “physical activity
in SM.
Discussion: e majority of pts with SM are sport inactive. e reasons
for this are fear of symptoms, especially allergic reactions, lack of motiva-
tion and possibly unawareness of the benecial eects of sport. e data
suggest that sport is feasible for many pts with SM and may reduce symp-
tom burden.
Conclusion: Intervention studies are justied and necessary to investigate
the eects of sport on SM symptom burden.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 255
1081
Eects of one-week skiing intervention on dynamic balance
and gait ability in brain tumor patients and their relatives
Nora Hansel1; Jule Rösener2; Johanna Jost3; Ralf Brandt3; Eric Eils2;
Dorothee Wiewrodt3
1Department of Neurosurgery, Münster University Hospital, Münster,
Deutschland
2Institute of Sport and Exercise Science, University Muenster, Münster,
Deutschland
1Department of Neurosurgery, Münster University Hospital, Münster,
Deutschland
Background: Brain tumor diagnosis deeply impact patients’ and their
relatives’ lives. Exercise interventions show potential to improve tness
levels and enhancing quality of life. Skiing, renowned for its combination
of endurance, strength, and balance provides a unique opportunity to pro-
mote stability. is study aims to assess eects of a 1-week skiing program
enhancing balance, gait ability, and improving quality of life (QoL).
Methods: is study is a non-randomized pre-/post trial for patients
with primary brain tumor (PBT) and their relatives. All subjects partic-
ipated in a 1-week ski excursion involving 4 hours daily either downhill
or cross-country skiing. QoL assessments occurred before (t1), during
(t2), aer intervention (t3). Y-Balance Test (YBT) and 6 Min Walk Test
(6MWT) were run at t1 and t3. Non-parametric statistics were used for
data analysis (P < 0.05).
Result: 12 subjects (4 male) aged of 48 ± 15.2 were involved. Including
7 patients, 6 with supra- and one with infracerebellar tumors (WHO 4:
71.4%, WHO 2: 28.6%). No signicant dierences were found between
male/female or patients/relatives. Aer intervention, YBT revealed a sig-
nicant increase in maximum range by 5.7-8.8% (p=0.028) (patients 5.1-
11.3%, relatives 5.6-8.2%). 85.7% of patients and 80.0% of relatives falling
below composite score of 94. In the 6MWT, median distance increased
58m (patients 590m to 638m, relatives 643m to 719m), and positively cor-
related with the balance increase (r=0.68, p=0.042). Anxiety and depres-
sive symptoms decreased, and self-ecacy increased in terms of QoL.
Discussion: e YBT results show dierences between le/right side,
mainly in anterior direction. is might be related to brain tumor loca-
tion. On average, patients showed greater improvements in YBT and
6MWT as their relatives.
Conclusion: A 1-week skiing program enhances balance, increases gait
ability and augments QoL comparable for PBT and their relatives. Using
YBT and 6MWT in PBT represents an innovative approach to capture gait
ability. Still, the limited sample size conducted further validation.
Disclosure Statement: e authors declare no conict of interest.
975
Factors inuencing physical activity in children and
adolescents during and after cancer: A systematic review.
Laura Kappelmann1; Miriam Götte2; Arno Krombholz3; Britta Fischer1
1Christian-Albrechts-Universität zu Kiel, Institut für Sportwissenschaft, Kiel,
Deutschland
2Westdeutsches Tumorzentrum Essen, Universitätsklinikum Essen, Essen,
Deutschland
3Ruhr-Universität-Bochum, Bochum, Deutschland
Background: Research has shown that childhood cancer survivors (CCS)
do not achieve the minimum recommended level of PA (1). erefore,
the aim of this review (2) was to identify the social, personal and con-
textual factors that inuence PA in CCS. It is hoped that the ndings can
optimise care in the future, recognising the need for multidisciplinary
collaboration.
Methods: SPORTDiscus, Cochrane, Web of Science, PubMed and FIS
Education electronic database were systematically searched.Result: e 13
out of 1849 included studies show the importance of social support, which
can fundamentally inuence PA and motivate to engage in PA. ere are
dierences according to treatment status, for example, parents are more
likely to prohibit PA in the active phase. Inhibiting personal factors are
concerns about infections or the general state of health. Another import-
ant contextual factor is whether a special exercise programme for CCS is
oered in the hospital or the spatial conditions.Discussion: Parents are
generally important supporters of PA. At the same time, concerns are
expressed that are not based on concrete facts, so inadequate information
could be discussed as a cause. Contextual factors inuence PA depending
on the setting and must always be considered in context and depending
on the treatment status.
Conclusion: e most important factor is personal health status. In addi-
tion, social and contextual factors can be identied as inhibiting and pro-
moting factors. It becomes clear that an interdisciplinary understanding is
necessary to increase the PA and to optimize care structures.
Indication of source:
1 Roussenq SC, Hintz LG, Rafael AD, et al. Level of physical activity and sedentary
behavior in children and adolescents diagnosed with cancer: a systematic review.
Int J Health Sci. 2022;16(3):54–63.
2 Kappelmann L, Götte M, Krombholz A, Hüter J, Fischer B.. Factors at
Inuence Physical Activity Behavior in Children and Adolescents During and
Aer Cancer Treatment: A Qualitative Systematic Review of the Literature.
Pediatr Exerc Sci. 2023 Oct 27:1-9.
Disclosure Statement: e authors declare no conict of interest.
994
The physical activity level in long-term survivors with
gynecological cancer - A preliminary analysis of the
“Survivorship Clinic for Long-term Survivors with
Gynecologic Cancer”
Johanna Porst1; Verena Krell1; Franziska Greiß1; Hannah Woopen2;
JalidSehouli2; Stephanie Roll3; Julia Alexandra Steinle2; Joana Baum2;
Petra Hühnchen4; Katharina Layer4; Kirsten Wittke5;
CarmenScheibenbogen5; Adak Pirmorady6; Matthias Rose6; Nicole Balint2;
Frank Edelmann7; Knut Mai8; Lukas Maurer8; Sandra Krabbe8;
MaxiNeubauer8; Eva Siebenhüner8; Reinhold Kreutz9; Engi Algharably9;
Fabian Maximilian Meinert10; Cindy Stoklossa11; Elisabeth Harmuth11;
Thomas Reinhold3; Stefan N. Willich3; Bernd Wolfarth1
1Abteilung Sportmedizin der Charité - Universitätsmedizin Berlin, Berlin,
Deutschland
2Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie der Charité –
Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland
3Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie der
Charité − Universitätsmedizin Berlin, Charité, Campus Mitte, Berlin, Deutschland
4Klinik für Neurologie der Charité − Universitätsmedizin Berlin, Charité -
Campus Mitte und Campus Virchow Klinikum, Berlin, Deutschland
5Fatigue-Zentrum, Charité – Universitätsmedizin Berlin, Campus Virchow-
Klinikum, Berlin, Deutschland
6Medizinische Klinik mit Schwerpunkt für Psychosomatik der Charité −
Universitätsmedizin Berlin, Campus Mitte, Berlin, Deutschland
7Medizinische Klinik mit Schwerpunkt Kardiologie der Charité –
Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland
8Medizinische Klinik für Endokrinologie, Diabetes und Stowechselmedizin der
Charité − Universitätsmedizin Berlin, Charité, Campus Virchow-Klinikum, Berlin,
Deutschland
9Institut für Klinische Pharmakologie und Toxikologie derCharité −
Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland
10Institut für Klinische Pharmakologie und Toxikologie der Charité −
Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland
11Sozialdienst der Charité – Universitätsmedizin Berlin, Campus Virchow-
Klinikum, Berlin, Deutschland
Background: e study ‘Survivorship Clinic for long-term survivors (LTS)
with gynecological cancer’, initiated by the Department of Gynecology,
Charité – Universitätsmedizin Berlin aims to promote quality of life in LTS.
A healthy and active lifestyle can reduce therapy-associated long-term side
eects [1]. erefore, sports medical consultations are part of this study.
Methods: A preliminary analysis of baseline data of the study’s interven-
tion group, conducted at the Department of Sports medicine, Charité
Berlin. Main inclusion criterion was the diagnosis of gynecological cancer
at least ve years ago. A detailed sports medical anamnesis was imple-
mented to depict every patient’s weekly physical activity (WPA) in relation
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts256
to the ocial guidelines [1]. ECG, blood pressure and pulmonary exercise
testing (CPET) indicated patients’ medical tness.
Result: In total, 163 of 192 (85 %) LTS attended a sports medical baseline
visit, 29 (15 %) did not attend due to medical risk factors or non-com-
pliance. Nine of 163 (6 %) could not perform the CPET due to medical
risks factors. Subsequently, 122 of 154 (79 %) were tested and certied as
medical t, 25 (16 %) as having limited tness and seven (5 %) were unt
to do sports. WPA ranged from zero to 23 hours (Mean=3.5, SD=4.3).
Overall, 46 of 163 LTS (28 %) were interviewed and reported no WPA at
all, 42 (26 %) engaged in less than 2.5 hours, while 75 (46 %) reported
more than 2.5 hours of WPA.
Discussion: Although, 79 % and 16 % were certied medical and limited
t, respectively, 54% did not meet the guidelines for WPA, 28% even with
no WPA at all. Baseline history and diagnostics revealed a great disparity
between the recommended ocial WPA guidelines and the actual WPA
levels in LTS.
Conclusion: ere is a great potential for improving WPA in LTS.
erefore, interventions to promote this behaviour are highly required.
Indication of Source:
1 Campbell, Kristin L., et al. “Exercise guidelines for cancer survivors: consensus
statement from international multidisciplinary roundtable.” Medicine and
science in sports and exercise 51.11 (2019): 2375.
Disclosure Statement: e authors declare no conict of interest.
1037
Communication between oncologists and general
practitioners in long-term care for cancer survivors
Sandra Salm1; Astrid Klein2; Meike Gerber3; Jennifer Engler1;
TeresaHalbsguth4; Karola Mergenthal1; Karen Voigt2; Corina Güthlin1
1Institut für Allgemeinmedizin, Goethe-Universität Frankfurt, Frankfurt am
Main, Deutschland
2Technische Universität Dresden, Universitätsklinikum Carl Gustav Carus, Bereich
Allgemeinmedizin / Medizinische Klinik und Poliklinik III, Dresden, Deutschland
3Technische Universität Dresden, Institut für Geschichte der Medizin, Dresden,
Deutschland
4Universitäres Centrum für Tumorerkrankungen Frankfurt, Sprechstunde
Langzeitnachsorge nach Krebs, Frankfurt am Main, Deutschland
Background: Following the completion of the ve-year cancer follow-up,
long-term monitoring usually shis to general practice. Oncologists encoun-
ter the challenge of determining the essential information to furnish to gen-
eral practitioners (GPs) to ensure adequate treatment of long-term eects
and early recognition of late eects. is study aims to explore the necessary
content and structure of reports to GPs regarding long-term cancer care.
Methods: Fourteen GPs were interviewed to gauge their perspectives on
the content and structure of hypothetical reports from long-term cancer
consultations. An inductive summary was employed to analyze the col-
lected data. Additionally, a think-aloud interview was conducted with an
oncologist engaged in long-term consultations to understand the process
of formulating reports for GPs.
Result: In the eld of oncology, emphasis is placed on presenting a clear con-
nection between patients’ complaints/symptoms, potential long-term/late
eects, and subsequent care provision. Consequently, oncologists’ reports
comprise continuous text. GPs expressed the need for tailored recommenda-
tions for long-term cancer care within primary care and a desire to compre-
hend the rationale behind suggested care procedures. ey favored a concise
format utilizing bullet points and tables over complex text sections.
Discussion: Divergent preferences between oncologists (as report trans-
mitters) and GPs (as recipients) concerning report structure are evident.
Oncologists prioritize complete traceability, whereas GPs seek rapid infor-
mation assimilation through succinct overviews.
Conclusion: e diering preferences observed in this study will be delib-
erated with interview participants in a workshop setting. e aim is to
generate mutual recommendations for preparing reports for GPs on long-
term cancer care.
Disclosure Statement: e authors declare no conict of interest.
1132
The additional therapeutic benet of physical activity in
a patient with BRCA1+ ovarian cancer: a case report with
11years follow-up
Anika Berling-Ernst1; Martin Halle2; Claudia Gross2; Melanie Heitkamp2;
Caterina Fiorentini2
1Klinik I für Innere Medizin, Universitätsklinikum Köln, Köln, Deutschland
2Präventive Sportmedizin und Sportkardiologie, Medizinische Fakultät, Klinikum
rechts der Isar, Universitätsklinikum der Technischen Universität München,
München, Deutschland
Background: A BRCA1 germline mutation is associated with an increased
lifelong risk of developing breast and/or ovarian cancer. However, the
penetrance varies individually, suggesting that lifestyle, e.g. physical activ-
ity (PA), may also inuence the occurrence and progression of cancer in
BRCA1 mutation carriers. Observational studies indicate that it may also
be possible to extend the disease-free survival time through PA. erefore,
maintaining cardiorespiratory tness (CRF) through PA is an important
component of oncological patient care during and aer tumor therapy.
Methods: A recreational athlete with a conrmed BRCA1 germline muta-
tion in her early 50s (baseline 2011: body mass index 19 kg/m2; VO2peak
27.2 ml/min/kg, 117% of normal value), diagnosed with poorly dierenti-
ated ovarian cancer (OC), underwent several tumor therapies and a pro-
phylactic bilateral mastectomy from 2011-2023. e postoperative tumor
classication was: pT3c; pN1(1/46), L0, V0, G3 stage IIIC according to
FIGO and UICC. e patient was continuously monitored by sports medi-
cine during the tumor therapy. CRF measured by VO2peak was documented
annually by using cardiopulmonary exercise testing (CPET) (n=11) from
2011-2023. In addition, VO2peak was recorded one week before, during and
aer chemotherapy administration (CTX) in 2022.
Results: Over the entire period, the patient was primarily physically active
with endurance sports in the form of cycling and running (at least 25-30
MET-h/week). In 2013, the patient completed a marathon and achieved
a VO2peak of 35.4 ml/min/kg (152% of norm value) in 2014. By 2022, the
VO2peak increased from one week before CTX (20.5 ml/min/kg 86% of
norm value) to the day of CTX (23.1 ml/min/kg 100% of norm value) and
was maintained above baseline one-week post CTX (21.5 ml/min/kg 89%
of norm value).
Discussion: CPET was suitable during and aer CTX as a control diag-
nostic to individualize and maintain the training program. In this case
study it could be shown that PA was feasible in every therapy phase and
could even be performed on the day of CTX.
Disclosure Statement: e authors declare the following: Mitarbeit an der S3 LL
zur Bewegungstherapie in der Onkologie
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 257
Sarcoma
1120
A rened cell culture method for characterization of Ewing
Sarcoma cell line phenotype and FET::ETS activity
A. Katharina Ceranski1,2,3; Martha J. Carreño Gonzalez1,2,3;
AnnaC.Ehlers1,2,3; Zuzanna Kolodynska1,2,3; Philipp Poeller4,5;
AlmutSchulze4; Shunya Ohmura1,2,3; Florencia Cidre-Aranaz1,2,3;
Thomas G. P. Grünewald1,2,3,6
1Hopp-Children’s Cancer Center (KiTZ), Heidelberg, Deutschland
2Division of Translational Pediatric Sarcoma Research, German Cancer Research
Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Deutschland
3National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership
between DKFZ and Heidelberg University Hospital, Heidelberg, Deutschland
4Division of Tumor Metabolism and Microenvironment, German Cancer
Research Center (DKFZ) and DKFZ-ZMBH Alliance, Heidelberg, Deutschland
5Faculty of Biosciences, Heidelberg University, Heidelberg, Deutschland
6Institute of Pathology, Heidelberg University Hospital, Heidelberg, Deutschland
Background: Ewing sarcoma (EwS) is an aggressive pediatric bone and
so tissue cancer. It is genetically characterized by FET::ETS fusion onco-
genes, mostly EWSR1::FLI1, encoding aberrant transcription factors. A
substantial part of EwS research relies on in vitro models. Yet, concerns
exist about their limited capability to adequately reect physiological
conditions. In this study we aim to improve EwS cell culture methods to
mimic physiological conditions more closely. In the advanced setup, we
characterize the phenotype of EwS cell lines and transcriptional activity of
FET::ETS fusion oncogenes.
Methods: Advanced medium composition and 3D culture technique
were used to culture EwS cell lines. We characterized the phenotype and
FET::ETS activity with dierent in vitro proliferation and viability assays,
RT-qPCR, transcriptome proling (Aymetrix Clariom D microarray)
and bioinformatic analyses.
Results: Principal Component Analysis (PCA) of transcriptome proling
data of EwS cell lines cultured in the standard versus rened setup reveals
sample clustering according to culture condition and cell line. Gene Set
Enrichment Analysis (fGSEA) of EwS cells grown in the rened cell cul-
ture shows enrichment for established EWSR1:FLI1 signatures as well as
pathways related to hypoxia, glycolysis, and cell signaling.
Discussion: EWSR1::FLI1 activity in the rened cell culture shows con-
sistency with established EWSR1::FLI1 signatures in standard conditions.
Yet, approx. 50% of dierentially expressed genes (DEGs) depending on
EWSR1::FLI1 activity in physiological cell culture are not shared with
DEGs recovered from EWSR1::FLI1 activity in standard cell culture.
is emphasizes the importance of rening cell culture methods for EwS
research.
Conclusion: Our rened cell culture setup is a suitable model for EwS
in vitro studies as it preserves EwS cell characteristics and better mim-
ics biological features of the tumor microenvironment, such as hypoxia.
Moreover, the technique is feasible, cost-eective and more ani-
mal-friendly than standard methods.
Disclosure Statement: e authors declare no conict of interest.
Skin Cancer including Melanoma
1130
Improved Melanoma Survival in Germany: A Registry-Based
Time Series Study
Laura Schumann1; Nora Eisemann1; Alexander Katalinic1; Hannah Baltus1;
Louisa Labohm1; Klaus Kraywinkel2
1Institut für Sozialmedizin und Epidemiologie, Lübeck, Deutschland
2Zentrum für Krebsregisterdaten, Robert-Koch-Institut, Berlin, Deutschland
Background: Since 2011, new treatment options specically for prog-
nostically unfavorable cutaneous melanoma are available, such as immu-
notherapies and targeted agents. Randomized controlled trials report
improvements in survival, but it is unclear if benecial eects are also
appearing on the population-level.
Methods: All patients with melanoma diagnosis (ICD10: C43) in 2000-19
were included from population-based cancer registries. Five-year relative
survival (5YRS) was calculated for four ve-year periods (2000-04, 2005-
09, 2010-14, 2015-19). To correct for temporal and regional dierences in
sex, age groups and UICC stage, standardization/stratication was per-
formed. Regression modelling was used to capture signicance (p<0.05)
of an expected time trend.
Result: We included 301,486 patients. e 5YRS improved from 93%
(2000-04) to 95% (2015-19) and in almost all investigated subgroups.
e largest increases occurred from 2010-14 to 2015-19, and there in
advanced melanoma, with 5YRS for stage UICC IV melanoma increasing
from 31% to 36% (relative dierence +16%). e overall survival trend
over all time periods showed a signicant improvement.
Discussion: In addition to new targeted therapies, other factors in care
and treatment, such as changes in registration or the introduction of
the national skin screening program, could have an impact on survival.
However, our analyses attempted to correct for these inuences, for exam-
ple by stage and age standardization or stage-specic analyses.
Conclusion: Over the past 20 years, survival of melanoma patients
improved signicantly. e largest improvements were seen for advanced
tumor stages from 2010-14 to 2015-19. is development strongly sup-
ports that the positive eects of new therapies that were observed in RCTs
are also evident population-based aer their approval.
Disclosure Statement: e authors declare no conict of interest.
Supportive Care
1090
Delayed chemotherapy-induced nausea – Occurrence and
corelates in a multi-center study in adult oncology patients in
clinical practice (CINrate)
Antje Koller1; Ramona Engst1; Agnes Glaus2; Rahel Hein3; Ulrike Mößner4;
Stefan Ott5; Andrea Kobleder5
1OST Eastern Switzerland University of Applied Sciences, Institute for Nursing
Sciences, St. Gallen, Schweiz
2Stiftung Onkologische Fortbildung und Kongresse (SONK), St. Gallen, Schweiz
3Spital Thurgau AG, Münsterlingen Cantonal Hospital, Oncology department,
Münsterlingen, Schweiz
4University Freiburg, Department of Internal Medicine, Haematology, oncology
and stem cell transplantation, gastroenterology, Freiburg, Deutschland
5OST Eastern Switzerland University of Applied Sciences, Department of
Economics, St. Gallen, Schweiz
Purpose: Nausea and vomiting negatively impact patients’ quality of life
and antitumor therapy. Delayed chemotherapy-induced nausea (dCIN),
especially with low (LEC) and minimally emetogenic systemic antitu-
moral therapy (MinEC), is oen underestimated in clinical practice. is
study aims to assess dCIN occurrence, focusing on LEC and MinEC, and
describe associated antiemetic therapy and patient characteristics.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts258
Methods: In a multicenter cross-sectional study, patients rated dCIN on
a VAS 0-100 in a daily diary. e primary endpoint was dCIN in LEC and
MinEC. Secondary endpoints were acute CIN (aCIN) and chemothera-
py-induced vomiting (CIV). e relationship between dCIN and sec-
ondary endpoints was determined with a multi-variate regression model
under control of the named risk factors.
Result: In three centers, 2 in Switzerland and 1 in Southern Germany,
172 patients were recruited. Of these, 31 (18%) had MinEC, 65 (38%)
had LEC, 61 (36%) had moderately and 15 (9%) had highly emetogenic
antitumoral therapy. Occurrence of dCIN in LEC was 19% (12 of 65;
95%CI 9.2/27.7) with a mean intensity of 31.5 (ranging from 12.5 to 60.8).
Occurrence of dCIN in MinEC was 3% (1 of 31; 95%CI 0/9.7) with a mean
intensity of 76.0. Overall, 31 patients (18%) experienced CIN with 17
patients (10%) experiencing signicant CIN (VAS>2.5). Only 3 patients
(2%) experienced vomiting. Risk factors for dCIN were determined in a
regression model.
Discussion & conclusion: In clinical settings, vomiting is gener-
ally well-managed, but CIN and especially dCIN still pose challenges.
Although occurrence rates have signicantly decreased, more data is
required to eectively manage dCIN in the remaining patients. Known
risk factors and current antiemetic regimens oer only limited support for
prevention. Clinicians must ensure not to miss out on those patients who
still suer from signicant CIN.
Disclosure Statement: e authors declare no conict of interest.
1148
The association between sleep problems and general quality
of life in cancer patients and in the general population
Dirk Hofmeister1,1; Anja Mehnert-Theuerkauf1; Thomas Schulte2;
AndreasHinz1
1Department of Medical Psychology and Medical Sociology, Leipzig University,
Leipzig, Deutschland
2Rehabilitation Clinic Bad Oexen, Bad Oeynhausen, Bad Oeynhausen,
Deutschland
Background: Sleep problems are frequent in cancer patients. Sleep quality
is associated with general quality of life (QoL). e aims of this study were
to analyze the relationship between sleep problems and other components
of QoL in more detail and to investigate sex and age dierences in sleep
quality in cancer patients in comparison with the general population.
Methods: is study comprised one general population sample (n = 4,476)
and eight samples with cancer patients (n between 323 and 4,020). Sleep
Quality was measured using the QoL questionnaire EORTC QLQ-C30.
Results: All of the cancer patient groups reported more sleep problems
than the general population. Sleep problems were associated with all facets
of QoL. e highest associations were found in cancer patients for fatigue
(r = 0.52) and emotional functioning (r = −0.47). e association between
sleep quality and general QoL was lower in the cancer samples (r = −0.37)
than in the general population (r = −0.46). e correlations between sleep
and global QoL are negative for all subgroups. is indicates a decreasing
quality of life with increasing sleep problems. Female and younger cancer
patients reported markedly more sleep problems than male (d = 0.45) and
older patients did (d = −0.17).
Discussion: e present study contributes to clarifying the magnitude
and role of sleep problems in the context of QoL. It underlines that sleep
problems are severe in cancer patients. e psychological QoL dimen-
sions are more strongly correlated with sleep problems than are the more
physical components.
Conclusion: e results o he study gives oncologists and other health
care providers information concerning groups with specic needs, espe-
cially females and young cancer patients.
Indication of source: Hofmeister, D., Schulte, T., Mehnert-euerkauf, A., Geue,
K., Zenger, M., Esser, P., Götze, H., Hinz, A. (2022). e association between sleep
problems and general quality of life in cancer patients and in the general popula-
tion. Front Psychol, 13, 960029.
Disclosure Statement: e authors declare no conict of interest.
1147
Evaluation of one-year data of a sports medical outpatient
clinic for cancer patients
Jessica Kuhn1; Verena Krell1; Franziska Greiß1; Johanna Porst1;
Tilman J. Pulst Caliman1; Bernd Wolfarth1
1Abt. Sportmedizin, Charité - Universitätsmedizin, Berlin, Deutschland
Background: In recent years, many studies have shown the benets of
exercise during and aer cancer treatment regarding therapy-associated
side eects. erefore, we established a sports medical outpatient clinic
for cancer patients (SOC) at the department of sports medicine, Charité –
Universitätsmedizin Berlin to provide individual exercise advice.
Methods: e SOC includes an oncologically focused anamnesis, a brief
check-up for evaluating the sports capability, individual exercise advices,
and, if needed, a referral to a training institution. We used data of SOC
from Aug 2022-Nov 2023 for descriptive analysis.
Result: 237 cancer patients (mainly breast cancer patients: n=133, 56.1%)
used the SOC during or aer cancer treatment (median=12 months,
range=0-478 months since cancer diagnosis). At the time of SOC, weekly
moderate and vigorous physical activity minutes ranged from 0 to 1500
(M=281, SD=252). 217 patients (91.6%) were referred to a training insti-
tution for a supervised resistance training.
Discussion: Although it appears that most of the patients meet the rec-
ommendations of 150 min of moderate or 75 min of vigorous physical
activity per week (self-report) [1], the demand for individual exercise
advice especially during cancer treatment is high. A possible reason for
this could be that many patients feel insecure about risking an increase in
cancer therapy-associated side eects due to the exercise training. Even
though a combination of aerobic and resistance training is recommended,
many patients have only been doing aerobic exercise before consultation.
erefore, most of them asked for a referral to a training institution to
start a resistance training.
Conclusion: e SOC is a valuable opportunity for cancer patients to
obtain information regarding exercise and help to (re-)start training.
erefore, there is a need for continuation and expansion.
Indication of source:
1 Schmitz KH, Courneya KS, Matthews C, et al. American College of Sports
Medicine roundtable on exercise guidelines for cancer survivors.Med Sci
Sports Exerc.2010;42(7):1409–1426.
Disclosure Statement: e authors declare no conict of interest.
1071
Establishing a centralized multidisciplinary unit for patient-
centered supportive care
Theres Fey1,10; Julia Demmelhuber2; Nicole Erickson1; Marina Schmid2;
Sylvia Tanzer-Küntzer3; Michael Schönberg4; Wolfgang Hiddemann5;
Markus Besseler6; Friederike Mumm1,7; Andreas Dinkel8; Hana Algül2,3,9;
Volker Heinemann1,2,10
1Comprehensive Cancer Center (CCC Munich LMU), Ludwig Maximilian
University (LMU) Hospital Munich, München, Deutschland
2Comprehensive Cancer Center Munich (CCC Munich), München, Deutschland
3Comprehensive Cancer Center (CCC Munich TUM), Klinikum rechts der Isar,
Technical University Munich, München, Deutschland
4Patient Advisory Board, Comprehensive Cancer Center Munich (CCC Munich),
München, Deutschland
5lebensmut e.V., Munich, München, Deutschland
6Bavarian Cancer Society e.V., Munich, München, Deutschland
7Department of Medicine III, Ludwig Maximilian University (LMU) Hospital
Munich, München, Deutschland
8Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts
der Isar, Technical University Munich, München, Deutschland
9Department of Internal Medicine II, Klinikum rechts der Isar, Technical
University Munich, München, Deutschland
10Bavarian Cancer Research Center (BZKF), Ludwig Maximilian University (LMU)
Hospital Munich, München, Deutschland
Background: As the landscape of cancer care becomes ever more multi-
faceted and complex, the incorporation of patient perspectives is critical
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 259
for the delivery of quality care. erefore, the CCC Munich, in coopera-
tion with the Bavarian Cancer Society and the charity lebensmut, aimed
to establish a centralized patient-centered (PC), low threshold, multidis-
ciplinary supportive care center capable of addressing patients’ individual
needs.
Methods: To ensure adequate incorporation of patient perspectives, a
patient advisory board worked together with a management board to plan
and establish the center. At every step, the focus remained on addressing
all aspects of PC care ranging from aesthetics to appropriate communica-
tion channels, and, most importantly, which supportive care requirements
to prioritize. Rooms were reserved for patient support groups to hold their
meetings. A central oce ensured an ease of coordinated care and man-
agement of patient enquiries.
Result: e CCC Munich patient center (Patientenhaus am CCC
München) was inaugurated in 2022. During the planning phase, patients
needs were evaluated, while structural and personnel requirements were
dened according to existing standards. Within the rst year, 4101 con-
sultations were carried out. ese included psychosocial support services
including programs for families, elderly and children (62 %), as well as
consultations with specialist from the areas of nutrition (26 %) and com-
plementary medicine (12 %). Presently, an integration of counseling ser-
vices for physical activity and pain management are being evaluated.
Discussion: e supportive care center sets a precedent for foundational
structures facilitating PC care. e patient advisory board ensured that
essential gaps and information needs were satisfactorily addressed.
Conclusion: Streamlined comprehensive supportive care is essential for
the delivery of high quality PC-care. e establishment of the supportive
care center sets the foundational structures required to adjust to, and ade-
quately address, the patient needs.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
992
Bridging the gap and providing support for seriously ill
patients and their families: The “Buddy intervention as a
result of the Dying at Home project.
Alina Kasdorf1; Raymond Voltz1; Julia Strupp1
1Uniklinik Köln, Köln, Deutschland
Background: e health and social care structures available for seriously
ill patients are still not always adequately used. For example, palliative care
is still provided late in the disease process, as opposed to early integration.
erefore, we wanted to dene elements of a complementary support sys-
tem for seriously ill and dying patients, based on specic experiences.
Methods: Qualitative interviews (patients & relatives, n=45) and focus
groups (health care professionals, n=22) were conducted and analysed
using framework analysis (Kasdorf et al. 2023).
Result: Informants described needs in emotional, informational, appraisal
and instrumental dimensions. Unmet informational needs were the most
frequently reported, aecting all other dimensions of need. To address
these concerns, informants expressed a need for someone to proactively
provide real-time support, organise respite care, provide feedback on care,
help understand the patient’s illness, or assist with nancial or legal issues.
Discussion: Inadequate knowledge of available treatment options aects
peoples multiple needs and increases the likelihood of death in hospital
(Kasdorf et al, under review). e implementation of a ‘buddy’ system
emerged as a potential solution to link current care structures and meet
the needs of patients and families. Seriously ill patients would be matched
with trained ‘buddies.
Conclusion: Following on from this project, the Buddy system has been
implemented in Cologne with funding from the Dt. Fernsehlotterie. It has
the potential to alleviate emotional distress, improve patients’ and fam-
ilies’ coping mechanisms and promote a better quality of life. Funding
from the Marga and Walter Boll Foundation is being used to evaluate the
implementation.
Indication of source:
1 Kasdorf, A., Voltz, R. & Strupp, J. e Buddy intervention: designing an
additional support system for the last year of life. J Public Health(2023).
2 Kasdorf, A., Voltz, R. & Strupp, J. (under review). Dying at home: What is
needed? A nationwide retrospective cross-sectional online survey of bereaved
people.
Disclosure Statement: e authors declare no conict of interest.
1088
Supporting the implementation of quality-assured
oncological exercise therapy in Germany: protocol of the
IMPLEMENT project
Melanie Reitz1; Mirko Brandes2; Anika Berling-Ernst1; Dominik Morlok3;
Annalena Wehner4; Bernardine Madl5; Patrick Jahn6; Thorsten Schmidt7;
Wiebke Jensen8; Miriam Götte9; Michael Leitzmann3; Hajo Zeeb2;
Freerk T. Baumann1
1CIO - Centrum für Integrierte Onkologie Uniklinik Köln, Köln, Deutschland
2Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS, Bremen,
Deutschland
3Universität Regensburg, Regensburg, Deutschland
4Ludwig-Maximilians-Universität München, München, Deutschland
5Technische Universität München, München, Deutschland
6Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland
7Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
8Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
9Universitätsklinikum Essen, Essen, Deutschland
Background: Quality-assured oncological exercise therapy (qOET) is
oen not implemented in routine cancer care, although it can improve
patient outcomes. erefore, the 3-year multicenter project IMPLEMENT
aims to develop, test and evaluate strategies to implement a sustainable
pathway to qOET with the primary goal to increase the overall number of
patients accessing qOET
Methods: IMPLEMENT uses a mixed-methods-approach to tackle bar-
riers and facilitators of the implementation of qOET, which are identied
at baseline. e project is structured by ve subprojects designing and
conducting strategies to implement qOET in specic settings and target
groups (e. g., urban vs. rural areas, adults vs. pediatric patients). Outcome
assessments occur at baseline, one- and two-years follow-up and are
guided by the RE-AIM framework, using questionnaires (patients: n=600;
stakeholders: n=210 per year) and semi-structured interviews and focus
groups (patients: n=24; stakeholders: n=24 per year). Outcome assess-
ments are used to revise and improve the implementation strategies of
each subproject. Project start was June 2023.
Result: IMPLEMENT aims at an increase (median 30%) of the number of
cancer patients that participate in qOET (primary outcome). Secondary
outcomes include the extension and adaption of qOET as well as an
increase of self-reported quality of life of cancer patients.
Discussion: Given the variety of stakeholder and patient groups involved
in the sustainable implementation of qOET, the interplay of various bar-
riers and facilitators in establishing qOET should be investigated further.
Innovative, evidence-based implementation strategies could then help to
overcome the identied barriers and promote facilitators. is could help
ensure sustainable access structures to qOET in Germany.
Conclusion: e use of eective implementation strategies may be bene-
cial for establishing qOET throughout Germany and could be promising
items to implement qOET in routine cancer care.
Disclosure Statement: e authors declare no conict of interest.
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Oncol Res Treat 2024;47(suppl 1):7–283 Abstracts260
Surgical Oncology including Robotics
1012
Feasibility study of sentinel lymph node diagnosis using free
ICG in testicular cancer patients
Yue Che1,1; Marieke Vermeulen1; Pailin Pongratanakul1; Sophia Thy1;
Peter Albers1
1UKD - Universitätsklinikum Düsseldorf- Urologische Klinik, Düsseldorf,
Deutschland
Background: Current staging methods at initial diagnosis fail to detect
occult metastasis in testicular cancer patients. Risk-adapted strategies to
reduce recurrence recommend adjuvant chemotherapy in cases of high
risk. Depending on testicular histology, 50% to 70% of those patients do
not need adjuvant chemotherapy. Since chemotherapy induced toxicity
is associated with considerable late toxicities and secondary malignan-
cies initial staging needs to be improved. Prior pilot studies investigat-
ing sentinel lymph node diagnosis using radioactive tracers in testicular
cancer patients have shown a high sensitivity (~90%) of the procedure.
erefore, we oered minimally-invasive sentinel lymph node biopsy
with free ICG to four patients with unequivocal testicular tumors in
clinical stage I.
Methods: Preoperative thoracoabdominal staging showed no evidence
of metastases in all patients. We performed laparoscopic or robotas-
sisted ICG-guided sentinel lymph node biopsy with simultaneous
orchiectomy in four men with initial diagnosis of testicular cancer in
clinical stage I.
Result: Sentinel lymph nodes were identied and resected in all patients
(see gure). e operations were well tolerated and no complications
regarding sentinel resection were observed.
Conclusion: Laparoscopic/robotic-assisted ICG-guided sentinel lymph
node detection with simultaneous inguinal orchiectomy in testicular
cancer patients is feasible. Sensitivity to detect occult metastatic dis-
ease of this novel technique will now be evaluated in a prospective trial
(RAISN).
Disclosure Statement: e authors declare no conict of interest.
Thoracic Cancer
1022
Amivantamab Plus Lazertinib vs Osimertinib as First-line
Treatment in Patients With EGFR-mutated, Advanced Non-
small Cell Lung Cancer (NSCLC): Primary Results From
MARIPOSA, a Phase 3, Global, Randomized, Controlled Trial
(Previously presented at ESMO Congress 2023, FPN:LBA14,
Byoung Chul Cho et al. - Reused with permission.)
Martin Schuler1; Byoung Chul Cho2; Enriqueta Felip3; Alexander Spira4;
Niolas Girard5; Jong-Seok Lee6; Se-Hoon Lee7; Yuriy Ostapenko8;
PongwutDanchaivijitr9; Baogang Liu10; Adlinda Alip11;
ErnestoKorbenfeld12; Josiane Mourão13; Tao Sun14; Melissa Martinez14;
Joshua Bauml15; Martin Shreeve16; Seema Sethi15; Roland Knoblauch15;
Hidetoshi Hayashi17; Shun Lu18
1Universitätsklinikum Essen, Essen, Deutschland
2Yonsei Cancer Center, Seoul, Republik Korea
3Vall d’Hebron University Hospital, Barcelona, Spanien
4Virginia Cancer Specialists, Fairfax, USA
5Institut du Thorax Curie Montsouris, Paris, Frankreich
6Seoul National University Bundang Hospital, Seongnam-si, Republik Korea
7Samsung Medical Center, Seoul, Republik Korea
8National Cancer Institute, Kyiv, Ukraine
9Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
10Harbin Medical Univ. Cancer Hosp., Heilongjiang, China, VR
11Universität Malaya, Kuala Lumpur, Malaysia
12Hospital Británico de Buenos Aires, Buenos Aires, Argentinien
13Hospital de Amor, Barretos, Brasilien
14Janssen Research & Development, Llc, Raritan, USA
15Janssen Research and Development, Spring House, USA
16Janssen R&D, San Diego, USA
17Kindai University Faculty of Medicine, Osaka, Japan
18Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong
University, Shanghai, China, VR
Background: Amivantamab (ami), an EGFR-MET bispecic antibody
with immune cell-directing activity, plus lazertinib (laz), a CNS-penetrant,
3rd-generation EGFR TKI, have demonstrated antitumor activity in phase
1 studies. MARIPOSA (NCT04487080) evaluated ami+laz vs osimertinib
(osi) in the rst-line setting.
Methods: Patients (pts) with treatment-naïve, EGFR-mutated (Ex19del or
L858R) locally advanced or metastatic NSCLC were randomized 2:2:1 to
ami+laz (open-label), osi (blinded), or laz (blinded). e primary end-
point was progression-free survival (PFS) of ami+laz vs osi by blinded
independent central review. Secondary endpoints included objective
response rate (ORR), duration of response (DoR), overall survival (OS),
and safety. Serial brain imaging was required.
Results: In total, 1074 pts were randomized (ami+laz, 429; osi, 429; laz,
216). Baseline characteristics were well balanced; median age was 63 years,
62% were female, 59% Asian, and 41% with history of brain metastases.
At a median follow-up of 22.0 months, the median PFS was 23.7 months
(95% CI, 19.1–27.7) for ami+laz and 16.6 months (95% CI, 14.8–18.5) for
osi (HR, 0.70; 95% CI, 0.58–0.85; P<0.001); this benet was consistent
across predened subgroups. ORR was 86% (95% CI, 83–89) for ami+laz
vs 85% (95% CI, 81–88) for osi, with median DoR of 25.8 months (95% CI,
20.1–NE) vs 16.8 months (95% CI, 14.7–18.5) among conrmed respond-
ers. At interim OS analysis, the medians were not reached; however, a
strong trend favored ami+laz vs osi with an HR of 0.80 (95% CI, 0.61 to
1.05; P=0.1).
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Oncol Res Treat 2024;47(suppl 1):7–283Abstracts 261
Ami+laz was associated with a higher rate of VTE; mostly grade 1-2,
occurring early, and eectively managed with anticoagulation. Higher
rates of EGFR- and MET-related AEs were seen with ami+laz vs osi.
Conclusion: Ami+laz provided statistically signicant and clinically
meaningful improvement in PFS vs osi with a numerically higher DoR
and a strong trend for improved OS. e safety prole of ami+laz was
consistent with prior reports. MARIPOSA establishes ami+laz as a new 1st
line standard of care for EGFR-mutated, advanced NSCLC.
Disclosure Statement: e authors declare that there are conicts of interest. e
conicts were submitted to the congress organizer KUKM GmbH and KUKM can
disclose them if needed.
Translational Oncology
1086
Radiation sensitivity is signicantly increased in patients with
systemic lupus erythematosus and the dose can be adjusted
for radiotherapy
Luitpold Distel1; Hannah Schenker1; Lukas Kuhlmann1; Rainer Fietkau1
1Strahlentherapie, Universitätsklinikum Erlangen, Erlangen, Deutschland
Background: ere are repeated clinical reports that patients with sys-
temic lupus erythematosus (SLE) have a higher risk of suering adverse
treatment eects. It is therefore assumed that these patients have an
increased radiation sensitivity. We studied 70 patients with SLE for their
radiation sensitivity. In the case of increased radiation sensitivity, we rec-
ommended a dose reduction for the therapy.
Methods: Using a G0-3C FISH assay of blood from patients, the radia-
tion sensitivity was determined via a score (breaks per metaphase, B/M)
of chromosomal aberrations. 37 non-oncological SLE and 33 SLE patients
with an oncologic disease were studied. Healthy individuals (n = 215)
and patients with breast (n = 147) and rectal cancer (n = 226) served as
controls.
Result: Patients with SLE were comparable in radiation sensitivity (B/M
0.40) to healthy individuals (B/M 0.41), but had signicantly more outli-
ers (10.8% > 0.6 B/M) to high radiation sensitivity comparable to patients
with breast (11.9%) or rectal cancer (11.6%). SLE patients with oncologic
disease have a signicantly increased mean radiation sensitivity of 0.52
B/M and a 24.2% outlier rate. e radiation sensitivity is clearly higher
than in patients with breast (B/M 0.45) or rectal cancer (B/M 0.44) (p <
0.007). A dose reduction of between 2% and up to 40% was recommended
for 11 patients. In two of these patients no radiotherapy was performed
and in 4 patients the dose was not reduced despite the recommendation.
5 patients received a dose reduction of up to 20%. None of the patients
developed a recurrence. One patient in whom the dose was not reduced
suered a serious adverse treatment outcome.
Discussion: Increased radiation sensitivity is found in all cohorts.
However, with very dierent numbers of increased radiation sensitivity
and severity.
Conclusion: Approximately 50% of SLE patients with oncologic disease
have a signicantly increased sensitivity to radiation. Reducing the dose of
radiation therapy is a practical way to avoid unwanted side eects.
Disclosure Statement: e authors declare no conict of interest.
1040
Analysis of ctDNA for the detection of minimal residual
disease (MRD) using a tissue-free, epigenomic assay in
patients with early-stage breast cancer - results from the
Success A study
Thomas W. P. Friedl1,1; Brigitte Rack1; Peter Andreas Fasching2;
AndreasHartkopf3; Hans Tesch4; Ralf Lorenz5; Georg Heinrich6; Jens-
UweBlohmer7; Tanja Fehm8; Volkmar Müller9; Andreas Schneeweiss10;
Matthias Beckmann2; Matthias Rübner2; Nadia Harbeck11; Klaus Pantel12;
Derek Dustin13; Mingyang Cai13; Wolfgang Janni1
1Frauenklinik, Universitätsklinikum Ulm, Ulm, Deutschland
2Frauenklinik, Universitätsklinik Erlangen, Erlangen, Deutschland
3Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Deutschland
4Onkologie Bethanien, Frankfurt, Deutschland
5Praxis Dr. Lorenz, N. Hecker, Dr. Kreiss-Sender, Braunschweig, Deutschland
6Schwerpunktpraxis für Gynäkologische Onkologie, Fürstenwalde, Deutschland
7Gynäkologie mit Brustzentrum, Charité-Universitätsmedizin Berlin, Berlin,
Deutschland
8Frauenklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
9Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-
Eppendorf, Hamburg, Deutschland
10National Center for Tumor Diseases (NCT), Heidelberg University Hospital and
German Cancer Research Center, Heidelberg, Deutschland
11Frauenklinik, LMU Klinikum München, München, Deutschland
12Institut für Tumorbiologie, Universitätsklinikum Hamburg-Eppendorf,
Hamburg, Deutschland
13Guardant Health, Palo Alto, CA, USA
Background: Current clinical guidelines do not recommend routine
screening for metastatic disease in patients with early-stage breast cancer
(EBC) unless there are clinical signs and symptoms. However, ctDNA may
serve as an early biomarker of recurrence which could facilitate identica-
tion of patients with asymptomatic distant metastases, who might benet
from early treatment intervention. Here, we utilized a tissue-free, epig-
enomic assay for the detection of ctDNA in patients with EBC.
Methods: Plasma samples were analyzed in 311 evaluable patients with
stage I-III EBC who were enrolled in the SUCCESS-A phase 3 clinical
trial (NCT02181101). All plasma samples were collected approximately
two years aer completion of adjuvant chemotherapy from patients with-
out evidence of prior disease recurrence. Samples were assessed blinded
to the clinical data using Guardant Reveal powered by Innity, which
evaluates the epigenomic signals associated with cancer versus normal
DNA for the detection of ctDNA, using an analytically validated bioinfor-
matics pipeline. Median survival times were estimated using the Kaplan-
Meier method and hazard ratios were calculated based on univariable cox
regression models.
Result: ctDNA was detected in 34% (13/38) of patients who subse-
quently developed distant recurrence (median time from sample col-
lection to recurrence 7.9 months, range 1.4-28.6 months), and in 60%
(9/15) of patients who had a sample collection within one year prior to
distant recurrence. ctDNA was detected in 6 patients without a docu-
mented disease recurrence, resulting in a specicity of 97.7% (260/266).
ctDNA detection was associated with a nearly 14-fold increased risk for
distant recurrence (HR 13.7, 95% CI 2.52-74.9; p<0.0001), and a 17-fold
increased risk for death (HR 17.4, 95% CI 1.33-227; p<0.0001).
Conclusion: Detection of ctDNA aer adjuvant chemotherapy was highly
prognostic in an EBC cohort. ctDNA testing warrants further investiga-
tion as a tool to identify EBC patients at high risk for recurrence during
follow-up who may benet from early interventions.
Disclosure Statement: e authors declare the following: D.D. and M.C. are em-
ployees of Guardant Health. All other authors declare no conict of interest.
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www.karger.com/ort
Autorenindex
A
Aaronson, N. 212, 536
Abada, P. 549, 578
Abbas, S. 282, 285
Abdallah, Al-O. 237
Abdollahi, A. 368
Abdulkhalek, H. 61, 149
Abdullah, Huda I. 804
Abicht, A. 577
Abonour, R. 43
Abou-Alfa, G. 351, 370, 377
Aboukors, T. 268
Abraham, K. 168
Abreu, Miguel H. 196
Acciu, S. 619
Acebo, R. 753
Acker, F. 947
Adeberg, S. 306, 368, 938, 1123, 1126
Adelberg, D. 818
Adler, M. 876
Admard, J. 1073
Aegerter, N. 605, 612, 614
Aerts, J. 674
Afthay, Kaywan A. 1084
AG Palliativmedizin Netzwerk
onkologische Spitzenzentren 385
Agaimy, A. 808, 951
Agius, M. 828
Aguado-Barrera, Miguel E. 481
Ahmad Khalil, D. 704, 717, 821
Ahmed, Helal Mohammed M. 712
Ahn, Jin S. 1018
Ahn, Myung-J. 360, 989
Ahrens, M. 100
Aigner, A. 901
Aigner, C. 511
Ailawadhi, S. 43, 237, 1060
Ajani, Jaer A. 70, 273, 367
Akbari, F. 168
Akerley, W. 674
Akolkar, D. 793
Akkas, G. 1143
Aktas, B. 107, 275, 314, 959, 961
Aktas, B. 960
Al Rabadi, H. 325
Al-Ali, H. 153, 186, 251, 984
Albers, P. 298, 802, 1012
Albrecht, M. 781
Albus, C. 687
Alcaniz, J. 600
Alencar, Alvaro J. 549, 578, 567
Aleric, I. 739
Aleshchenko, E. 56
Alexander, P. 767
Alfonso, Pilar G. 502
Algharably, E. 994
Algül, H. 650, 856, 1071
Alip, Adlinda 1022
Allak, A. 909
Allan, John N 343
Allgöwer, Chantal 1076
Allum, W. 779
Al-Madhi, S. 619
Al-Nawas, B. 160
Al-Sawaf, O. 578
Alsolivany, J. 1143
Altena, R. 536
Altmannshofer, S. 483
Altomare, I. 455
Álvarez López, Isabel M. 536
Alwan, M. 251
Amann, N. 452, 506
Amatangelo, M. 335
Amaya Chanaga, C. 70
Amirpour-Mehrhof, N. 283, 346, 408, 668
Ammer-Herrmenau, C. 876
Ammon, A. 20
Ammon, N. 782
Anchang, Charles G. 79
Andag, R. 798
Anders, M. 817
Andersohn, F. 984
Andrassy, J. 1015
Andratschke, N. 769
André, T. 818
Andre, V. 423, 1085
Andreou, D. 686, 825
Andric, Z. 62, 674
Angell, H. 1074
Angerbauer, S. 803, 836
Angerer, M. 49
Angermeier, S. 188
Anke, U. 267
Antoch, G. 802
Antonuzzo, L. 345, 372, 375
Apel, K. 49
Apeltrath, C. 1064
Aperghis, M. 345
Apfelbacher, C. 56
Apostolidis, L. 1020
Aragon-Ching, J. 37
Arance, A. 388
Ardeshna, K. 262
Ardizzoni, A. 108
Arens, C. 597
Aretz, S. 979
Armeanu-Ebinger, S. 1073
Arndt, K. 686
Arndt, V. 236, 298
Arni, P. 545
Arnold, D. 491, 502, 565
Arnold, M. 594
Arnold, N. 275
Arnulf, B. 43, 237, 1060
Arolt, C. 893
Arrarás, Juan I. 212, 1011
Arriola, edurne 999, 1108
Arslan, C. 995
Arsov, C. 802
Ascierto, Paolo A. 388
Asendorf, T. 327, 503, 700
Asim, Z. 704, 717
Asmussen, S. 408, 787
Assaf, Z. 175
Assahub, M. 233
Assenat, E. 351
Asuzano, A. 1138
Atmaca, A. 360, 989
Atzpodien, J. 875
Auber, B. 275
Audigier-Valette, C. 571
Aufenberg, B. 777
Augustin, M. 1020
Aulitzky, Walter E. 768
Autry, Robert J 44
Avilion, A. 262
Awada, A. 182
Ayala, R. 251
Aydogdu, C. 100
Azevedo, S. 351
Aznar-Peralta, I. 524
Azria, D. 481
Azqueta Gavaldon, M. 1074
B
Baader, T. 672
Baas, P. 360
Babiak, A. 636
Babiak, C. 636
Bachanek, S. 834, 839
Bachet, Jean-B. 711
Backman, M. 212
Baehr, A. 75, 358, 379, 528
Baerens, Dirk-T. 61
Bahlis, Nizar J 43, 1060
Bähr, O. 811
Balint, N. 994
Baltus, H. 1130
Bajwa, N. 260
Balbas, M. 549, 567
Baldus, S. 96, 744
Balduzzi, A. 672
Balic, M. 49
Balk, M. 758, 808
Ball, C. 734
Baltas, D. 750, 890
Balzer, K. 419
Bamias, A. 1057
Banerjee, S. 270
Banerji, V. 278
Bangemann, N. 912
Downloaded from http://karger.com/ort/article-pdf/47/Suppl. 1/7/4169504/000535363.pdf by guest on 05 March 2024
Oncol Res Treat 2024;47(suppl 1):7–283Author Index 263
Baran, C. 951
Barbato, F. 228
Bardelli, A. 305
Bardia, A. 214
Barlesi, F. 1018
Barnes, B. 629
Barreau, Y. 709
Barrett, C. 1074
Barrios, C. 175, 196
Barth, T. 732
Barth, U. 591, 597
Bartl, T. 450, 744
Bartsch, Detlef K. 856
Bartsch, R. 49, 61
Barzel, A. 1122
Bäsecke, J. 191
Bassermann, F. 748
Bastians, H. 876
Battista, M. 154, 183, 290, 593
Batus, M. 62
Batzianouli, E. 804
Bauer, L. 49
Bauer, L. 306, 938
Bauer, N. 812
Bauer, S. 233, 704, 717, 821
Bauer-Büntzel, C. 773
Baues, C. 378
Baum, F. 581
Baum, J. 994
Baumann, E. 594, 681
Baumann, Freerk T. 35, 240, 638, 807,
923, 932, 946, 1088
Baumann, L. 769
Baumann, S. 190, 843
Bäumer, C. 704, 717
Baumgarten, P. 831
Baumgartl, M. 769
Baumhoer, D. 825
Bauml, J. 1022
Baurecht, H. 990
Bausewein, C. 195, 354, 371, 670
Baust, K. 56, 207, 630
Bayer, O. 878
Baz, R. 237, 334, 1060
Baz, David V. 989
Bechmann, I. 901
Beck, F. 852
Beck, J. 589
Beck, M. 528, 551
Beck, S. 598
Becker, C. 618
Becker, H. 661
Becker, H. 630, 675
Becker, J. 331
Becker, K. 577
Becker, L. 44
Becker, N. 802
Becker, S. 48, 51
Becker, S. 345
Becker, S. 949
Beckmann, H. 121, 582
Beckmann, Matthias W. 402, 483, 484, 541,
624, 747, 810, 1040
Bedir, A. 134
Beer, A. 732
Beghdad, F. 61
Behr, J. 885
Behrens, H.-M. 1058
Behrens, S. 644
Behringer, D. 689
Behringer, K. 318, 589
Beierlein, M. 483
Beil, J. 595
Bekaii-Saab, T. 818
Belka, C. 769, 877
Belle, S. 913
Beller, R. 240, 431, 916
Belloso, J. 536
Beltzig, L. 1103
Ben Hamed, H. 153
Bence-Lin, A. 1131
Bende, K. 1124
Bendrich, S. 327
Bendszus, M. 610, 861, 867
Benet-Pagès, A. 858
Benjamin, R. 1060
Benner, A. 644, 802
Bennstein, Sabrina B. 916
Benz, S. 892
Benz, Stefan R. 581, 629
Berdeja, J. 1060
Berdel, W. 712
Bergatt-Kuhl, B. 271
Bergbold, S. 298
Berger, A. 853, 856
Berger, K. 650, 786
Berger-Höger, B. 650
Berghmans, T. 674
Bergmann, Anke K. 594, 782
Bergner, D. 211
Berking, C. 561
Berling-Ernst, A. 990, 1088, 1132
Bernabe Caro, R. 62, 571
Bernardi, C. 673, 701
Bernauer, E. 1026
Berndt, U. 486
Berner, R. 952
Bernhardt, D. 1084
Bernstein, S. 584
Berressem, S. 558, 687, 693
Berry, M. 384
Bertemes, H. 620
Besseler, M. 878, 1071
Bette, M. 325
Beule, D. 332, 449
Beutel, Alica K. 1141
Beuzeboc, P. 1057
Beverungen, D. 76
Bey, I. 696
Bhatnagar, R. 43, 237, 1060
Biebl, M. 417
Bielack, S. 825
Bier, S. 655
Bigot, F. 995
Bijlsma, Rhode M. 536
Bilici, M. 1000
Bilsing, B. 707
Binder, C. 246
Bini, F. 153
Birkhold, M. 873
Bischof, G. 190, 843
Bischo, M. 689
Bischo, P. 376, 396
Blanc, E. 332, 449
Blanc, Jean-F. 708
Blanck, O. 854
Blase, C. 821
Blatt, S. 160
Blau, W. 689
Blaum, T. 275
Blaurock, M. 424
Blay, Jean-Y. 301
Blazejczyk, K. 632
Bleckmann, A. 246, 514, 947
Blees, A. 697
Blickle, P. 210
Bloch, W. 536, 672
Blohmer, Jens-U. 283, 346, 364, 668,
912, 1040
Blome, C. 121
Blöß, S. 819
Blum, S. 571
Blümcke, B. 275
Blumenschein Jr, G. 360
Blütgen, S. 740
Bochtler, T. 995
Böck, S. 88
Bockelmann, A. 876
Boda-Heggemann, J. 854
Bodensohn, R. 358
Boehmer, U. 27
Boekels, R. 833, 842
Bögemann, M. 37, 74, 116, 265
Böger, D. 447
Bogeski, I. 764
Bohle, R. 1124
Böhler, P. 282
Böhlke, L. 638
Böhm, C. 1136
Böhmer, D. 319, 816
Böhmer, G. 355
Bohne, A. 230, 439
Bohnenkamp, H. 878
Boileau, J.-F. 175
Boje, Ammelie S. 800
Bojovic, V. 723
Bokemeyer, C. 35, 240, 247, 406, 557,
569, 572, 637, 733, 737,
738, 965
Böker, A. 709
Bokhua, D. 956, 958
Boklage, S. 576
Bolenz, C. 913, 1122
Bolli, M. 612
Bolm, L. 446
Bolt, T. 885
Bölükbas, S. 511, 756
Bondarenko, I. 1018
Bonifacio, M. 251
Bonilla del Rio, Z. 764
Bonke, Lars A. 424
Borchmann, P. 262, 318, 378, 589
Bordogna, W. 1018
Borger, V. 516, 945
Borges, G. 926
Borghaei, H. 571
Borgmann-Staudt, A. 207, 630
Borgwardt, Luca-P. 962
Borkar, S. 700
Borkhardt, A. 888
Borkowetz, A. 986
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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index264
Borm, K. 1084
Bornhäuser, M. 686, 859, 866
Börries, M. 581, 620, 661
Bösche, J. 560, 687, 713
Boschung, K. 1136
Boshnakovska, A. 764
Bossart, M. 661
Bosse, K. 1095
Böthig, J. 594
Böttcher, C. 376
Böttcher, S. 308
Böttinger, R. 809
Bouattour, M. 66
Boukovala, M. 786
Boulet, T. 1053
Bourgeois, M. 239, 875
Bourjlian, Shogheeg A. 260
Boxberg, M. 598, 851
Boyer, L. 673, 701
Boyle, F. 1085
Bragagnoli, A. 70
Brägelmann, J. 893
Brahmer, Julie R. 571
Braicu, Elena I. 107
Brand, M. 268
Brandes, M. 1088
Brandt, R. 1081
Braner, H.-U. 1112
Brasó-Maristany, F. 484
Bratan, T. 667
Braulke, F. 327
Braumann, C. 770, 776
Braun, Felix L. 411
Braun, R. 446
Brecht, P. 745
Breder, V. 377
Brehmer, B. 906
Breitbach, M. 741
Breitbart, Eckhard W. 859, 920
Breitling, A. 513
Breitschuh, D. 687, 713
Bremen, R. 467
Brenner, H. 585, 651
Brenner, W. 183
Breuel, S. 845
Brieu, N. 1074
Bridge, H. 343
Brieger, J. 647
Briers, E. 481
Brigitte, S. 594, 782
Brinkers, M. 940
Brix, G. 135
Bröckelmann, Paul J. 318, 847
Broehl, M. 721
Broge, B. 499
Broijl, A. 43, 1060
Bronsert, P. 446, 724, 795, 944
Brose, M. 1133
Brossart, P. 304
Brown, Jennifer R. 549
Brucker, C. 107
Brückl, W. 274, 947
Brückner, L. 541
Bruges, R. 70
Brüggemann, M. 76
Brümmendorf, Tim H. 467
Brunner, C. 460
Brunner, F. 308
Brunner, T. 854
Bruns, Christiane J. 88, 590, 856, 934
Bruns, G. 878
Bruns, J. 629
Brust, Lukas A. 411
Brüstle-Wild, A. 1009
Brzezicha, B. 600
Brzoska, P. 909
Büch, T. 901
Buchele, C. 769
Buchholz, M. 770, 776
Buchholz, S. 856
Büchler, B. 212
Budach, W. 854
Budczies, J. 598, 851
Budginaite, E. 767
Bugaj, Till J. 178, 185, 659
Buhl, C. 455
Bühnen, I. 318
Bukatz, J. 396
Bullinger, L. 396, 1143
Bultijnck, R. 1011
Büntzel, J. 447, 458, 773
Büntzel, J. 381, 429, 773, 780, 790
Burger, L. 911
Burgers, Jacobus A. 571
Burkhardt, V. 618
Bürkle, Sophia L. 890
Burner-Fritsch, I. 670
Burotto, M. 1057
Burris, H. 66
Büscher, A. 613
Busenhart, P. 657
Bushong, J. 571
Buss, E. 999
Butea-Bocu, Marius C. 54
Büthe, L. 381
Butler, M. 271
Buttmann-Schweiger, N. 829
Büttner, R. 716, 893, 965, 1136
Byrd, John C. 278
C
Cabrieto, J. 697
Cai, M. 1040
Caia, A. 43, 237, 334, 1060
Cairns, L. 149
Calaminus, A. 893
Calaminus, G. 35, 56, 207, 240, 630
Califano, R. 62
Callander, N. 334, 1060
Cameron, S. 910
Campbell, A. 1
Canão, P. 767
Capdevilla, J. 711, 1133
Capper, D. 291, 368, 396
Carbasse, C. 435
Cardona, A. 1018
Cardoso, R. 585
Cario, G. 526
Carmen Garrido-Navas, C. 524
Carreño Gonzalez, Martha J. 1120
Carreras, Francisco G. 784
Cartron, G. 262
Casadei, N. 1073
Castro, G. 62
Castro Oliden, V. 1000
Casuscelli, J. 100, 906
Catanzariti, L. 893
Cathomas, R. 100
Cavo, M. 334, 1060
Ceranski, A. Katharina 1120
Cercek, A. 711, 818
Ceresoli, G. 574
Chaganti, S. 722
Chalabi, N. 995
Chan, Stephen L. 351, 370, 377
Chandak, A. 384, 918
Chang-Claude, J. 481, 644
Chao, J. 367
Che, Y. 1012
Cheah, Chan Y. 549, 567, 578
Chelik, G. 865
Chen, C. 43, 334, 1060
Chen, C. 140
Chen, E. 711
Chen, G. 94
Chen, H. 735
Chen, Jen-S. 66
Chen, Ming-H. 708
Cheng, Ann-L. 351
Cheng, Y. 1108
Chiang, M. 918
Chima-Melton, C. 384, 918
Cho, Byoung C. 360, 1022
Cho, L. 576
Choidas, A. 184
Chong, G. 502
Choquet, S. 722
Choritz, L. 665
Choudhury, A. 481
Chow, Edward Kai-H. 682
Christalle, E. 379
Christen, Deborah K. 1089
Christmann, J. 1055
Christmann, M. 1103
Christoph, D. 445, 755, 756, 947
Christoph, J. 153
Chui, S. 175
Chul Cho, B. 1056
Cicin, I. 423
Cidre-Aranaz, F. 1120
Cinci, M. 833, 842
Ciuleanu, Tudor-E. 571
Civardi, T. 335
Claaßen, K. 298, 848, 882
Clark, A. 722
Claßen, Noa M. 729
Claus, K. 754
Clauss, D. 212, 536
Cleary, James M. 70, 273
Clemens, P. 528
Clemens, R. 828
Cluzeau, T. 336, 1051
Cobo, M. 674
Cobo, Manuel A. 989
Cobo Dols, M. 1056
Coburger, J. 518
Cocks, K. 1131
Coen, L. 862
Cohen, G. 66, 372, 708
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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 265
Cohen, J. B. 549, 567
Coker, S. 251
Colombo, N. 270
Combs, S. 1084
Combs, Stephanie E. 1125
Comoli, P. 722
Compton, Richard G. 735
Conrads, K. 876
Constantinovici, N. 94
Cook, M. 43, 237, 334, 106
Cook, N. 995
Coombs, Catherine C. 549, 578
Corbacioglu, S. 759
Cordesmeyer, L. 828
Cornelissen, R. 989
Corradini, S. 769
Cortes, J. 214, 1085
Cossmann, L. 874
Costa, I. 1076
Costa, Luciano J. 43, 334, 1060
Coto-Llerena, M. 609
Cox, A. 906
Crawford, D. 37, 74, 83
Croner, R. 517, 542, 550, 619,
621, 765, 954
Cruz, Felipe J. 74
Cruz, J. 196
Csapo-Schmidt, C. 368
Csűry, Anna Z. 758
Csűry, Tamás D. 758
Cuba, L. 22, 109
Cundom, J. 375
Cunningham, D. 779
Curigliano, G. 214, 762
Cymbalista, F. 278
Cytera, C. 207
D
Dabrowski, C. 576
Dahiya, S. 262
Dahl, E. 184
Dahlho, M. 726
Dahlmann, M. 267
Dahlum, S. 732
Dallal, A. 866
Dallmeier, D. 268
Danchaivijitr, P. 1022
Damaschin, C. 589
Damm, F. 343
Dannecker, C. 295, 537, 747
Dannehl, D. 741, 931
Dantes, Z. 468
Danzer, K. 1141
Dao, Tu V. 377
Dareskog, I. 664
Darr, C. 55, 95, 116, 228, 233, 906
Darsow, M. 515
Darwiche, K. 511, 1070
Das, S. 251
Dasari, A. 502
Dau, L. 384
Daubmann, A. 569
Daum, S. 856
Davenport, E. 140
Davids, Matthew S. 343
Davies, M. 61
Dayyani, F. 370
de Boer, C. 798, 962
De Bruin, N. 462
de Buhr, R. 49
de Gregorio, N. 107, 270
de Groot, Jan Willem B. 388
de Lazzari, N. 916
de Ligt, Kelly 1011
de Marinis, F. 576, 999, 1018
de Ruysscher, Dirk R. 481
De Toni, E. N 377, 1063
de Vrieze, M. 802
de Wit, M. 858
Debatin, Klaus-M. 426, 806
Debus, Jürgen P. 306, 769, 802, 938
Degerli, E. 415
Degulys, A. 336, 1051
Deiters, B. 276
Delank, S. 164
Delbridge, C. 1084
Delforge, M. 43, 334, 1060
Delmonte, A. 674
Deloch, L. 311
Demidov, G. 1095
Demmelhuber, J. 1071
Demmler, R. 79
Deng, M. 306, 938
Dengel, A. 462
Dengler, R. 403
Deniz, M. 801
Denkinger, M. 268
Dennert, G. 27
Denz, R. 1055
Denzlinger, C. 809
Depenbusch, J. 212, 536
Depke, M. 800
Deppe, I. 916
Derigs, P. 688, 911
Dernbach, G. 1136
Der-Torossian, C. 384
Desuki, A. 514, 714
Deutschmann, C. 253
Dexheimer, N. 1129
Dhanda, D. 1060
Di Bartolomeo, M. 711
Di Nicolantonio, F. 305
Di Pietro, A. 388
Diamante, G. 426
Didion, J. 884
Diehl, V. 378, 1084
Diels, J. 697
Diemert, S. 107
Dieng, S. 476
Dienstmann, R. 301
Diepers, A. 186
Diéras, V. 762
Dierickx, D. 722
Dierks, S. 798
Dierlamm, J. 378
Dieterich, M. 175
Dietlein, M. 378
Dietrich, A. 734
Dietrich, M. 973
Dietz, A. 615
Dietz, T. 560
Dikow, N. 275
Dimicoli-Salazar, S. 336, 1051
Dinkel, A. 1071
Dinkel, H. 55
Dirksen, U. 916
Distel, L. 297, 1086
Ditsch, N. 275, 295, 537
Dittmann, F. 828
Dittmar, T. 837, 841
Dittmer, K. 13
Dittrich, L. 417
Divarci, Reyhan R. 775
Djordjevic, M. 773
Dobiasch, S. 52
Doehn, C. 745, 868, 919, 922
Doerner, L. 518
Döge, C. 558
Doherty, Gary J. 345
Döhner, H. 732
Dolf, A. 792
Doll, K. 866
Dölvers, F. 645, 649, 690
Dooms, C. 1131
Domschikowski, J. 52
Dörje, F. 22, 80, 109
Dornhöfer, N. 314, 959, 960, 961
Dor-On, E. 702
Dörr-Jerat, Niels M. 324
dos Santos, Telma M. 367
Dossow, K. 619
Dracke, F. 560
Dragomir, Mihnea P. 1136
Drebber, U. 716
Dreger, P. 688
Dreiack, N. 331
Dreismann, L. 362
Dreismickenbecker, E. 333, 547, 672
Drewes, J. 940
Dreyling, M. 262, 567
Drießen, S. 93
Drilon, A. 1108
Dröge, Leif H. 327
Dröge, P. 56
Drzezga, A. 754
Duan, X. 722
Dubois, C. 594
Dudys, P. 653
Dugan, M. 893
Duhn, J. 446
Düll, J. 583
Dummer, R. 388
Durán-Pacheco, G. 995
Dürr, P. 22, 751
Dürst, M. 355, 573
Dustin, D. 1040
Duwe, G. 462, 735
Duyster, J. 620, 661
Dwinger, S. 35, 240
Dyer, Martin J. S. 817
Dziadziuszko, R. 62, 1018
E
Eaton, M. 674
Eberhardt, J. 862
Eberhardt, W. 511, 1070
Eberl, M. 496
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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index266
Eberle, F. 1123
Ecker, J. 694, 814, 852
Eckstein, M. 758, 1124
Edelmann, F. 994
Edemir, B. 186
Edgar, S. 267
Ecace, F. 1011
Egenolf, T. 100, 906
Egger-Heidrich, K. 207
Ehlers, Anna C. 1120
Eich, Hans T. 1054
Egle, D. 49
Egyed, M. 278
Ehlert, S. 153
Ehret, F. 52, 291, 311, 358, 368, 396, 729
Eich, Hans-T. 378
Eich, Marie-L. 716, 754
Eichenauer, Rolf H. 868, 919, 922
Eichkorn, T. 306
Eichler, MSc., M. 686
Eilers, L. 350, 544
Eils, E. 1081
Einhell, S. 433, 701, 781
Einsele, H. 43, 237, 583
Eisele, L. 697
Eisemann, N. 1130
Eisen, A. 181
Eisen, C. 1074
Eisfeld, C. 233, 882
Eixelberger, T. 913
Ekmekciu, I. 1055
Elamin, Y. 1108
Elbracht, M. 979
Eli Gabayan, A. 1056
Eliason, L. 1060
Elisei, R. 1133
El Rajab, I. 672
El Shae, R. 327, 528
Elimova, E. 70, 140, 273
Ellenrieder, V. 764, 876
El-Marouk, K. 415
Elmers, S. 35, 240
Elter, T. 760, 899
Emmanuel, K. 493
Emmerson, J. 779
Emrich, K. 219
Eng, C. 502
Engebraten, O. 484
Engler, J. 1037
Engel, C. 275
Engel, H. 890
Engel, T. 170
Engert, A. 318
Engst, R. 143, 1090
Entlicher, M. 1008
Erber, R. 402, 810
Erbes, T. 661, 719
Ercan, C. 609
Erdmann, G. 653
Erices-Leclercq, M. 96, 744
Erickson, N. 990, 1063, 1071
Ernst, J. 796, 874
Ernst, M. 484, 624
Ernst, T. 447, 663
Escherich, G. 630
Eskoer, B. 483
Esposito, I. 785, 888, 965
Esposito, O. 251
Esser, Heinz-W. 899
Esser, K. 864
Ettrich, Thomas J. 188, 351, 531, 856,
884, 1141
Evers, G. 246, 947
Evesque, L. 66
Exner, Jan-P. 719
Eyl-Armbruster, Ruth E. 187, 809
Eyre, Toby A. 549, 567, 578
Eysel, P. 946
Eze, C. 415
F
Fabbri, G. 1074
Faber, J. 35, 207, 240, 333, 547, 630, 672
Fabian, A. 311
Facon, T. 335
Faehling, S. 437
Fahkri, B. 549
Fahmer, N. 444
Faker, F. 797
Fakhri, B. 567
Falk, M. 660
Faller, H. 444
Fam, F. 343
Farazi, T. 262
Fasan, O. 262
Fasching, Peter A. 402, 483, 484,
541, 624, 810, 1040
Fasolo, A. 351
Fasshauer, M. 910
Fassunke, J. 521, 736
Faust, M. 847
Faust, U. 1095
Feder, I. 1055
Fehm, T. 275, 402, 747, 810, 862,
864, 917
Fehn, T. 659, 1040
Fehrenbach, Michael K. 518
Feiten, S. 966
Felbor, U. 787
Feldmann, G. 239, 304
Feliciano, J. 273
Felip, E. 360, 1022
Feller, A. 236
Felser, S. 366, 424, 1089
Felten, J. 43, 237, 334, 1060
Fenaux, P. 336, 1051
Fendler, W. 228, 705, 848
Ferdinandus, J. 378, 589
Ferentinos, K. 755
Fernandez, Maria Elena E. 502
Fernández-Zapata, C. 376
Fernando, N. 1056
Ferrajoli, A. 260, 278
Ferrant, E. 278
Ferreira, L. 468
Ferro, A. 301
Fervers, P. 590
Fetzner, D. 446
Feuerbach, M. 984
Feufel, M. 283, 408, 409, 787
Fey, T. 786, 990, 1063, 1071
Fichtner-Feigl, S. 856
Ficker, J. 274
Fieber, V. 859, 866, 920
Fiengo Tanaka, L. 357, 495, 496, 829
Fietkau, R. 297, 808, 811, 1086
Filian, J. 1057
Fink, A. 402, 810
Fink, C. 769
Finke, I. 249
Finkelmeier, F. 66
Finogenova, K. 804
Fiorentini, C. 1132
Fischer, B. 975
Fischer, H. 646
Fischer, H. 797
Fischer, J. 327
Fischer, L. 239
Fischer, Laura A. 327
Fischer, M. 667
Fischer, Rieke N. 847
Fischer, T. 754
Fischer von Weikersthal, L. 188, 1020
Fishman, H. 702
Fiuza-Luces, C. 672
Fizazi, K. 37, 74, 83, 265
Flachmann, M. 838
Flaherty, Keith T. 388
Flatmark, K. 761
Flaucher, M. 483
Flebbe, H. 559
Flegar, L. 906
Flethe, C. 450
Fleury, I. 262
Flieger, D. 689
Flinn, Ian W. 278, 549, 567
Flock, C. 178, 185
Flockerzi, F. 616
Flohr-Schmitt, E. 878
Fogliatto, Laura M. 278
Folkerts, Jan H. 714
Follmann, M. 391, 747
Follows, G. 260, 278
Foltz, L. 784
Fong, Chung Y. 251
Forberger, M. 961
Forkel, H. 800
Forstbauer, H. 689
Förster, F. 96, 744
Förster, R. 96, 744
Forsting, M. 511
Fouad, Tamer M. 345
Foukakis, T. 484
Fox, F. 581
Fox, Maria L. 784
Fragoso Costa, P. 228
Francis, P. 536
Frank, D. 712
Franke, B. 581, 629
Franke, Gabriele H. 215
Franke, Georg-N. 76, 676
Franke, S. 757, 844
Franke, S. 615
Franken, A. 862, 917
Franz, S. 211
Freitag, D. 831
Freitag, M. 890
Fremd, C. 536
Frentsch, M. 1136
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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 267
Frerich, B. 436
Freudlsperger, C. 306, 938
Frevert, Marie L. 741, 931
Freyer-Adam, J. 190, 843
Fridh, M. 672
Friederich, Hans-C. 185
Friedetzky, A. 722
Friedl, A. 187
Friedl, Thomas W. P. 402, 810, 917, 1040
Friedrich, C. 1136
Friedrich, N. 716
Friess, H. 856
Friker, Lea L. 363, 945
Fritz, R. 1136
Fröhlich, D. 813
Fröhling, S. 332, 449
Fromm, Martin F. 22, 80, 109
Frontzek, F. 1054
Frost, N. 396, 947, 1136
Früh, A. 396
Frühwald, M. 630
Fuchs, J. 306, 938
Fuchs, M. 318, 378, 589
Fuentes Pradera, J. 1056
Führer, D. 1133
Führes, Hannah S. 221
Fujera, M. 584
Fürst, A. 230, 417, 439
Furuse, J. 351, 370, 377
G
Gaebel, J. 615
Gaertner, B. 190, 843
Gahr, S. 385
Gaidzik, Verena I. 732, 884
Gainey, M. 719, 890
Gaisa, Nadine T. 732
Galy, G. 345
Gallardo, C. 70
Galldiks, N. 847
Galle, Peter R. 377
Gallmeier, E. 188, 856
Galsky, M. 1057
Gamelin, L. 722
Gao, S. 345, 1133
Garbaos, G. 345
Garbe, C. 388
Garbrock, K. 1137
Garcia-Carbonero, R. 502
Garcia-Manero, G. 336, 1051
Garcia-Marquez, Maria A. 88, 590
García-Sancho, Alejandro M. 262
Garhöfer, F. 610, 861, 867
Garrido, M. 70, 1000
Garrido, P. 1131
Gartner, L. 816
Gärtner, M. 966
Gasimli, K. 949
Gasimli, N. 949
Gašpert, T. 1011
Gast, M. 827
Gastinger, I. 954
Gastl, B. 702, 1143
Gattenlöhner, S. 965
Gaube, R. 650
Gauer, T. 134
Gauß, G. 431
Gauler, T. 1070
Gaulton, Kyle J. 1138
Gauss, Silja 1095
Gawish, A. 1123, 1126
Gebauer, J. 35, 145, 207, 240, 675
Gebauer, N. 419
Gebel, C. 833, 842
Gebhart, M. 315
Geboes, K. 273
Gedenk, C. 236
Gehrig, A. 275
Geissler, E. 561
Geissler, J. 301
Geissler, M. 856
Geissler, Mark E. 866
Gelse, N. 878
Gempt, J. 518
George, D. 94
Geppert, C. 1124
Gerber, D. 674
Gerber, M. 1037
Gerdes, B. 856
Gerds, Aaron T. 540
Gergis, U. 43
Gerhardt, A. 308
Gerken, M. 414, 417, 581, 710
Gerlach, L. 447
Gerlo, X. 44
Germer, C.-T. 1015
Gerstenmaier, U. 732
Gerstner, G. 62
Gerwert, K. 158
Gesell, D. 195, 371
Gesewsky, L. 828
Geßner, C. 342
Geulen, J. 699
Geyer, Charles E. 1053
Geyer, L. 726
Ghadimi, M. 559, 856, 865
Ghadjar, P. 890
Ghesquieres, H. 262
Ghia, P. 278, 549, 578
Ghilotti, F. 697
Gholami, Mohammad F. 376
Ghosh, S. 1136
Gibhardt, C. 764
Gieringer, R. 647
Giesinger, J. 1011
Giesemann, N. 866
Giesen, N. 809
Giladi, M. 702
Gildemeister, J. 211
Gilks, B. 959, 960, 961
Gillen, K. 154, 183, 290, 593
Gilligan, A. 1131
Gillmore, R. 375
Giralt, S. 237, 334, 1060
Girard, N. 1022
Girard, N. 989
Gisder, D.-M. 1055
Gisinger, S. 524
Giuseppi, Ana C. 336, 1051
Gkika, E. 52, 719, 854
Glaß, B. 1054
Glagau, S. 912
Glanemann, F. 947
Glas, M. 811
Glasstetter, M. 49
Glaus, A. 1090
Glausch, M. 859, 866, 920
Gleim, N. 235
Glogner, J. 56
Glossmann, Jan-P. 271
Gmeiner, C. 796
Goerling, U. 668, 874
Goetz, Matthew P. 423, 1085
Goetze, Thorsten O. 188
Goetzenich, A. 331
Gogas, Helen J. 388
Goh, Yeow T. 784
Göhler, T. 191
Golas, M. 275, 295
Goldbrunner, R. 742, 811
Goldmann, J. 107
Gollrad, J. 709
Golpon, H. 700
Gonnelli, A. 729
Gonzalez-Carmona, Maria A. 304
Goossens, C. 541, 624
Göring, W. 239, 888
Gossler, C. 100
Gostian, Antoniu-O. 758, 808
Goto, H. 262
Goto, K. 1108, 1131
Goto, Y. 360
Götte, M. 431, 672, 916, 975, 1088
Gottlieb, Robert L. 384, 918
Gottlieb, T. 469
Gottschling, S. 1112
Götze, T. 656
Gout, J. 531, 1141, 1138
Grabarczyk, P. 800
Grabow, D. 207
Grabowski, M. 550
Grabowski, P. 48, 51, 393, 827
Grabsch, H. 767, 779
Gracian, Antonio C. 502
Grade, M. 559, 865
Gradetzke, Felia M. 15
Gradhand, E. 873
Graf, A. 452
Graf, J. 390
Graf, K. 425, 501
Grages, A. 268
Grah, C. 393, 632
Grapp, M. 178, 185
Gräsel, J. 952
Gräßel, L. 620, 661
Grassi, M. 433
Gratze, K. 49
Gratzke, C. 890
Graupe, F. 856
Greco, N. 143
Greeske, A. 760, 899
Greiß, F. 994, 1147
Greil, C. 813
Greil, R. 378, 589, 674
Greiner, J. 809
Greiner, W. 663, 777
Gretser, S. 873
Greulich-Bode, K. 699
Greve, J. 268
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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index268
Grieb, G. 48, 51, 393
Griech, N. 630
Griesinger, F. 342, 576, 685, 700, 999
Griesshammer, M. 784
Grigull, L. 979
Grimm, Marc-O. 276
Grimm, T. 1146
Grisanti, S. 1056
Grochowski, P. 698
Groenvold, M. 1011
Grohé, C. 574
Grohmann, M. 75, 134, 311, 379, 528
Grootscholten, C. 273
Groschek, M. 689
Groß, J. 48, 51
Gross, C. 1132
Gross, J. 759
Groß, P. 724
Grosser, B. 698, 779
Großer, S. 984
Großerüschkamp, F. 158
Große-Thie, C. 424
Grosso, F. 574
Groß-Opho-Müller, C. 760, 899
Grosu, Anca-L. 719, 750, 880, 890
Grün, B. 813
Grundler, E. 230, 417, 439
Grünewald, Thomas G. P. 1120
Grünwald, V. 55, 95, 100, 116, 233,
455, 875, 906
Gscheidle, S. 594
Gschwend, J. 802
Guarneri, V. 196, 423
Guberina, M. 511
Guberina, N. 511, 1070
Guckenberger, M. 769
Guenzel, C. 388
Guhlich, M. 327
Gül-Klein, S. 761
Gunasekara, N. 212
Günther, S. 181, 276
Guntinas-Lichius, O. 447, 573
Gupta, C. 377
Gupta, R. 384, 918
Gupta, Ravi G. 571
Gupta, V. 914
Gupta, Vineet G. 66
Gust, R. 315
Gutbrod, M. 838
Guth, D. 107, 191
Güthlin, C. 1037
Guthrie, V. 372
Gutiérrez-Enríquez, S. 481
Gütz, S. 689
Gutzmer, R. 388
Guyon, V. 944
H
Ha, Hai M. 52
Haack, T. 1073, 1095
Haaf, Léonie H. 1049
Haak, F. 609, 614
Haas, S. 688
Habenberger, P. 184
Haber, A. 702
Haberl, C. 858
Häberle, L. 239, 785, 888
Häberlin, J. 636
Hackl, T. 213
Hackshaw, A. 301
Hadaschik, B. 55, 95, 116, 228, 233,
455, 802
Haderlein, M. 808
Hadoux, J. 1133
Haefner, N. 956, 958
Haensel, B. 4
Haering, C. 874
Hafemann, Mia M. 427
Haferkamp, A. 462
Haferkamp, S. 561
Hagedorn, L. 637, 692
Hagemann, I. 355
Hagemann, J. 247
Hagemeier, A. 358
Hagemeyer, B. 213
Hähling, D. 308
Hahn, S. 239, 847
Hahn, S. 770
Hahnen, E. 275
Haidinger, R. 151
Haidn, U. 1063
Haim, D. 734
Halbsguth, Teresa-V. 207, 1037
Halfen, J. 700
Halfter, K. 91
Hall, R. 989
Halle, M. 1132
Hallebach, V. 732
Hallek, M. 271, 378, 740, 760, 847, 899, 946
Haller, F. 965
Hallermayr, A. 524, 584, 803, 836, 858
Halloul, Z. 591, 597
Hallsson, L. 1049, 1134
Hamacher, L. 760
Hamacher, R. 233
Hamilton, E. 182, 214, 762, 1085
Hamm, Anna F. 828
Hamm, I. 13, 646
Hamm, J. 764
Hammerer, P. 83
Hampl, M. 355
Han, B. 1108
Han, H. 1108
Handke, A. 55
Handtke, J. 729
Hänel, M. 308, 378
Hanke, D. 655
Hänle, M. 531, 1141
Hansel, A. 573
Hansel, C. 821
Hansel, N. 1081
Hanselmann, J. 49
Hansen, Finn K. 901
Hansen, H. 934
Hansen, T. 845
Hansinger, J. 581
Harbeck, N. 49, 61, 151, 175, 196,
275, 423, 1040, 1085
Harbottle, R. 911
Hardt, A. 358
Härle, A. 1138
Harke, N. 802
Harmuth, F. 1073
Harmuth, E. 994
Harpole, D. 345
Harrison, C. 540
Härter, M. 221
Harter, P. 270
Hartkopf, A. 402, 741, 810, 931, 1040
Härtl, K. 1146
Hartmann, A. 124, 402, 810
Hartmann, N. 965
Hartz, T. 629
Hasenburg, A. 154, 183, 290, 593
Hassel, Jessica C. 715
Hatschek, T. 484
Hattenhauer, T. 875
Hatzipanagiotou, Maria E. 710
Haufschild, C. 569
Hauke, J. 275
Haupt, N. 646
Hauschild, K. 125
Hautzel, H. 756, 989, 1022
Havel, L. 62, 674
Hayati, S. 336
He, Aiwu R. 351, 708
He, F. 934
He, Z. 1057
Hechenbichler Figueroa, S. 829
Heckelmann, B. 446
Hecker-Nolting, S. 825
Heese, O. 349
Hegg, R. 175
Hegi, M. 1103
Hegmann, N. 1089
Heidelbach, J. 760, 899
Heidenreich, A. 55, 693, 778, 946
Heider, K. 375
Heiland, S. 610, 861, 867
Heimann, M. 945
Hein, R. 1090
Heindl, Ludwig M. 923, 932
Heinemann, V. 650, 711, 786, 818,
900, 1063, 1071
Heinen, J. 390
Heinen, P. 271
Heininen-Brown, M. 1074
Heinrich, G. 1040
Heinrich, S. 143
Heinzelbecker, J. 1124
Heintz, C. 803, 836
Heinzerling, L. 561
Heise, C. 634
Heise, T. 759
Heiser, L. 734
Heißer, T. 585, 651
Heisserer, B. 672
Heist, R. 360
Heisterkamp, N. 761
Heitkamp, M. 1132
Heitmeir, B. 801
Heitplatz, B. 116
Heitzer, E. 858
Hekmat, K. 1136
Held, I. 91
Held, T. 306, 938
Heldwein, M. 1136
Hellmich, M. 646
Hellmis, E. 94
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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 269
Helm, B. 797
Hemicker, T. 626
Hemmati, P. 308
Hempel, E. 868, 919, 922
Henke, M. 880
Henkel, J. 577
Henninger, G. 605
Hennings, A. 629
Henrique, R. 1124
Hentschel, L. 686
Henze, F. 151
Herber, M. 492
Herbst, S. 364
Herhaus, P. 318
Hering, D. 134
Hering, K. 52
Hering, R. 853
Herishanu, Y. 278
Herkommer, K. 802
Herling, M. 76, 535
Hermann, M. 874
Hermann, S. 127, 298, 741, 931
Hermeling, S. 694
Hernández Rivas, Jésus M. 251
Hernández-Boluda, Juan C. 540
Hernandez-Ilizaliturr, F. 567
Herold, K. 699
Herold, N. 275
Herold-Mende, C. 1034
Herr, W. 673, 701
Herrlinger, U. 363, 792, 945
Herrmann, H. 450
Herrmann, J. 720
Herrmann, K. 228, 455, 511
Herrmann, M. 891
Herrmann, P. 761
Herrmann-Johns, A. 673, 701
Hessel, H. 1074
Hertel, F. 599, 724
Hertenstein, B. 378
Herter, S. 44
Herzog, J. 738
Herzog, K. 620
Hess, Gabriel F. 605, 609, 612, 614
Hess, J. 656
Heßmann, E. 876
Hester, A. 275
Hester, B. 121
Hetterich, M. 710
Hettich, J. 565
Heudobler, D. 673
Heukamp, L. 700
Heumann, P. 481, 644
Heurgué, A. 377
Heuschmann, P. 444
Heuer, V. 1055
Heurich, M. 1026
Heuser, M. 712
Heuser Preuvot, S. 322
Heydt, C. 736
Heymach, John V. 345
Heyne, S. 796
Hickmann, E. 250
Hiddemann, W. 1071
Hielscher, T. 1084
Hiensch, Anouk E. 536
Hies, J. 673
Hildebrand, B. 419
Hildebrand, Laura S. 297
Hilgendorf, I. 35, 240
Hille, A. 798
Hillemanns, P. 355, 1049, 1134
Hiller, R. 959, 960, 961
Hillmer, A. 893
Hilpert, F. 270
Hilpert, F. 860
Hilser, T. 55, 95, 100, 116, 875
Hinke, A. 188
Hinneburg, J. 786
Hinske, Ludwig C. 295, 537
Hinz, A. 1148
Hippler, M. 518
Hirschberg, L. 151
Hirsemann, A. 436
Ho, Anthony D. 688
Ho, C. 578
Hoang, L. 960, 961
Hochmair, M. 62, 345, 1018
Hodiamont, F. 195, 354, 371
Hoegen, P. 769
Höer, A. 984
Hofbauer, C. 866
Ho, A. 1133
Hoart, J. 501
Hoknecht, P. 947
Homann, C. 511
Homann, J. 600, 871
Homann, J. 306, 938
Homann, Marc S. 567, 578
Homann, T. 268, 460
Homann, W. 350, 410, 453, 544, 965
Homeister, M. 585, 651
Hofheinz, Ralf-D. 445
Hoacher, A.-M. 1049
Hofmeister, D. 1148
Höfner, T. 462
Högner, M. 748
Hogrefe, C. 49
Hohenberger, P. 255
Hohls, L. 630
Höhn, Anne-K. 959, 960, 961
Höhn, P. 770, 776
Hohwieler, M. 1076
Hoier, D. 760, 899
Holch, J. 990
Holinski-Feder, E. 524, 577, 584, 803,
836, 858, 979
Holland-Letz, T. 44
Hollerbach, S. 1055
Homayounfar, K. 1112
Holmblad, M. 375
Holtick, U. 535
Hölscher, T. 986
Holtkamp, U. 391
Holz, B. 893
Holz, K. 610, 861, 867
Holze, M. 53
Hölzel, M. 792
Holzgreve, A. 705
Holzinger, J. 493
Holzner, B. 1011
Hönig, K. 204
Honselmann, K. 446
Hopfer, O. 676
Hoppenrath, L. 744
Horak, P. 332, 449
Horenkamp-Sonntag, D. 56
Horinouchi, H. 1018
Horn, K. 748
Horn, Lars-C. 959, 960, 961
Hornburger, H. 583
Horneber, M. 813
Hornemann, B. 874
Hörner, M. 541
Hörner-Rieber, J. 769
Horny, K. 888
Hörsch, D. 1020
Horst, D. 376, 396, 1136
Hou, Helen X. 1084
Hövel, P. 874
Hoyer, H. 355
Hoyer, Philine-S. 962
Hriskova, K. 670
Hsieh, Meng-C. 363, 792
Hu, M. 1133
Huang, C.-S. 1053, 1085
Huang, L. 468
Huberth, L. 116
Hübner, G. 689
Hübner, H. 483, 484, 541, 624
Hübner, J. 213, 458
Huemer, F. 62
Huesmann, S. 402, 810
Hufnagl, C. 493
Hughes, M. 278
Hühnchen, P. 994
Huhnold, Laura M. 764
Hummel, H.-D. 965
Hums, Anna-B. 573
Hunger, T. 135
Huober, J. 423, 1085
Hurvitz, Sara A. 214
Hüsing, J. 848, 882
Hussain, M. 37, 74, 83
Hutchinson, K. 1075
Hüttmann, A. 378
Huwa, L. 837
Huwer, S. 931
Hyeong Lee, K. 1056
Hyung, Woo J. 1000
I
Ianotto, Jean-C. 251
Ibrahim, N. 182
Idel, C. 268
Idler, C. 768
Ihle, Michaela A. 521, 736
Ihle, P. 56
Ihrig, A. 878
Iida, S. 1060
Ikeda, M. 372
Ilin, L. 634
Illerhaus, G. 187, 809
Illert, L. 620, 661
Illmer, T. 331
Im, S.-A. 1075
Ingermann, J. 803, 836
Inwald, Elisabeth C. 710
Iqbal, M. 674
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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index270
Iro, H. 758, 808
Isfort, S. 467
Isaev, P. 1133
Isgandarov, A. 95
Ishaque, N. 305
Italiano, A. 995
Ivanyi, P. 55, 100, 875, 906
Iwata, H. 175
Izutsu, K. 262, 549, 578
J
J. Chisamore, M. 1056
Jacob, Anne S. 589
Jacob, Noelle S. 729
Jacobasch, L. 188
Jaeger, B. 755
Jaehde, U. 80
Jaehnig, T. 1122
Jafari, A. 304
Jagadeesh, D. 549, 578
Jagannath, S. 237, 1060
Jäger, B. 275
Jäger, E. 425, 501
Jäger, M. 599, 724
Jäger, U. 262
Jahn, P. 1088
Jagla-Franke, M. 215
Jäkel, N. 186
Jakob, D. 661, 741
Jakob, J. 255
Jakobs, F. 418, 525, 965
Jakobs, J. 697
James, D. 343
Janjigian, Yelena Y. 70, 1000
Janni, W. 402, 732, 801, 810,
917, 1040, 1122
Janoski de Menezes, J. 995
Jänsch, R. 621
Jansche, R. 801
Jansen, L. 573
Jansen, L. 255, 931
Jansky, M. 371
Janssen, Klaus-P. 694, 726, 814, 852
Janssen, M. 116
Janssen, S. 528
Janssens, A. 278
Jarzab, B. 1133
Javorniczky, R. 620
Jayavelu, Ashok K. 712
Jayne, S. 817
Jazmati, D. 358, 854
Jechorek, D. 597, 621, 757, 844
Jegannathen, A. 61
Jelgersma, C. 396, 1143
Jenke, Robert G. 901
Jens Peter, von K. 267
Jensch, A. 187, 809
Jensen, W. 240, 1088
Jentschke, E. 170
Jentschke, M. 1049, 1134
Jentzsch, M. 76, 359, 676
Jerónimo, C. 1124
Jeschke, U. 295, 537
Jhaveri, K. 1075
Jiang, P. 358
Jilg, Cordula A. 890
Jochem, L. 860
Joensuu, H. 37, 74
Johannsen, M. 868, 919, 922
John, U. 190, 843
Johnson, H. 804
Johnston, Stephen R.D. 196, 423, 1085
Jöhrens, K. 734
Jokisch, F. 694
Jonas, C. 521, 736
Jonášová, A. 336, 1051
Jonigk, D. 184
Joos, M. 53
Joos, S. 17, 256, 347, 813
Jordan, K. 445
Jost, Jo. 1081
Jorzick, C. 406, 737
Joussen, A. 709
Juhasz-Böss, I. 599, 661, 719, 724, 741,
795, 931, 944
Juhnke, S. 819
Jünemann, B. 798
Jung, J. 620, 661
Jung, Kyung H. 175
Jung, W. 589
Junghanß, C. 308, 366, 424, 1089
Jungmann, P. 741
Jungnickel, B. 926
Junker, M. 462
Junker, K. 1124
Jurczak, W. 278, 549, 567, 578
Juric, D. 1075
Jurkschat, R. 884
Justenhoven, C. 211, 219, 298, 714
K
Kaag, D. 15
Kaaks, R. 481, 802
Kaatsch, P. 56
Kachel, P. 476, 635
Kadel, S. 583
Kaess, C. 759
Känger, K. 452, 506
Kaftan, H. 447
Kager, L. 825
Kahl, B. 262
Kahl, C. 308
Kahl, T. 228
Kahn, J. 368
Kähnert, H. 564
Kaina, B. 1103
Kajüter, H. 95, 233, 298, 848, 882
Kal, J. 304
Kalil, Andre C. 384, 918
Kalinauskaite, G. 551
Kalinowski, U. 366
Kalinsky, K. 1075
Kalmadi, S. 674
Kalmbach, N. 346, 364, 668, 912
Kamdar, M. 278
Kämmerer, P. 160, 647
Kämpfe, D. 186, 308, 1089
Kamps, M. 890
Kang, Yoon-K. 367, 377
Kania, M. 502
Kansy, B. 704, 717
Kanz, F. 636
Kao, S. 62
Kappelmann, L. 975
Karamouzis, M. 70
Karbe, Anna-G. 396
Karli, T. 614
Karlsson, K. 278
Karpel-Massler, G. 806
Karpinski, M. 848, 882
Karras, F. 757, 844
Karthaus, M. 445
Kasahara, N. 325
Kaschdailewitsch, E. 256, 347
Kasdorf, A. 992
Käsmann, L. 358, 415
Kasper, B. 255, 686
Kasper, P. 847
Kasper, S. 492
Kasper-Virchow, S. 875
Kästner, A. 350, 544, 965
Katalinic, A. 1130
Katalinic, D. 615, 675, 739
Katalinic, M. 615
Kather, A. 958
Kathleen S, K. 665
Katz, J. 335
Kaumann, P. 503, 977
Kaumann-Guerrero, D. 885
Kaumann, L. 1019
Kaufmann, J. 358
Kaufmann, M. 768
Kaul, D. 291, 368, 396, 729, 1143
Kaul, M. 62
Kaur, S. 557, 572
Kauth, V. 462
Kawaoka, T. 351
Kawashima, J. 540, 784
Kaya, S. 647
Kayser, G. 618
Keam, B. 1133
Kearney, M. 181, 276, 745
Keck, T. 446
Keeperman, Karen L. 336, 1051
Keil, F. 378
Keilholz, U. 305, 332, 449, 645, 649,
690, 735, 1136
Kelch, S. 346
Keller, U. 332, 449
Kelley, K. 351, 377
Kelly, Ronan J. 273
Kemper, M. 246
Kemper, M. 734
Kendel, F. 283, 408, 409, 787
Kerek-Bodden, H. 629
Keric, N. 518
Kerkho, A. 589, 947
Kerßenboom, R. 697
Kersting, D. 455
Kersting, S. 892
Kesch, C. 228
Keßler, Almuth F. 518
Keßler, T. 524, 584, 803, 836
Kesting, M. 933, 939, 942, 950
Kesting, S. 990
Kestler, A. 856, 884, 1122
Kestler, H. A. 1122, 1141
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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 271
Kevric, M. 825
Khalmurzaev, O. 1124
Khamis Hassan, A. 996
Khan, J. 94
Khan, N. 94
Khandanpour, C. 712, 748, 828
Kiechle, M. 275, 452, 468, 506
Kiehl, F. 916
Kiehl, M. 676
Kiermeier, S. 77, 127
Kiesslich, T. 493
Kiewe, P. 308
Kiladjian, Jean-J. 251
Kim, Jee H. 370
Kim, Jin W. 66
Kim, Moon-S. 455
Kim, Sung-B. 182
kim, y. 625
Kimmich, C. 308
Kim-Wanner, Soo-Z. 249, 581
Kirchen, H. 714
Kirchho, F. 100
Kirschner, M. 239, 521
Kirste, S. 750, 890
Kisro, J. 492
Kissinger, G. 366
Kist, Andreas M. 758
Kistner, C. 153
Kitano, M. 66
Kitazono, S. 360, 989
Kitt, K. 426
Kittai, Adam S. 343
Kiver, V. 762
Klaas, O. 803, 836
Klafke, N. 813
Klapper, W. 378
Klar, E. 366
Klauschen, F. 332, 449, 965, 1136
Klausz, K. 800
Klebl, B. 184, 267
Kleesiek, J. 228, 455
Kleger, A. 531, 1076, 1138, 1141
Kleihues-van Tol, K. 581
Klein, A. 1037
Klein, E. 452, 506
Klein, I. 856
Klein, K. 283, 408, 787
Klein, L. 876
Klein, M. 56
Klier, J. 868, 919, 922
Kliesch, S. 655, 723
Klieser, E. 493
Klindworth, R. 208
Klinge, K. 748
Klinger, C. 1015
Klinghammer, K. 332, 449, 875
Klinkhammer-Schalke, M. 414, 428,
581, 629, 710
Kloecker, G. 674
Kloft, M. 767
Kloker, Linus D. 595
Klöppel, G. 1020
Klose, P. 760
Klostermann, A. 877
Kloth, M. 1129
Klotz, R. 53
Klötzer, C. 359
Kludt, E. 681
Klug, S. 357, 495, 496, 829
Klüter, S. 769
Knauf, W. 331
Knauthe, N. 859, 866, 920
Knebel, M. 411
Kneissig, M. 837
Knippen, S. 528
Knispel, E. 828
Knoblauch, R. 1022
Knödler, A. 364
Knoefel, Wolfram T 888
Knoll, M. 368
Knolle, J. 324
Knop, S. 748
Knopf, F. 862
Knott, A. 1053
Knott, M. 187, 809
Knüttel, H. 230, 439
Ko, Yon-D. 589
Kobe, C. 378, 754
Kobelt, D. 267, 761, 871
Kobleder, A. 143, 1090
Koch, A. 917
Koch, C. 668
Koch, I. 1136
Koch, M. 808
Koch, O. 493
Koch, P. 926
Koch, R. 748
Koch, T. 1089
Köchel, A. 558
Kocher, M. 742
Kock-Schoppenhauer, Ann-K. 207
Kocsis, J. 502
Köditz, Anne-K. 874
Koeksal, M. 304
Kofahl, C. 899
Koh, Y. 567
Köhler, A. 175, 492
Köhler, M. 35, 240, 285
Kohlhas, V. 664
Kokh, D. 504
Kolb, M. 1137
Kolbe, O. 665
Koll, P. 847
Koller, A. 143, 1090
Koller, J. 877
Koller, M. 701, 428, 781
Köllermann, J. 228
Kollikowski, A. 240
Kollmar, O. 605, 609, 612, 614
Kolmhuber, S. 670
Kolodynska, Z. 1120
Komor, O. 956
Komrokji, Rami S. 336, 1051
Konda, B. 672
Kondo, K. 140
Konecny, Gottfried. E. 270
König, Alexander-O. 375, 856
König, C. 524
König, F. 868, 919, 922
König, I. 145, 207, 748
König, J. 777
König, M. 296
Königsrainer, A. 595
Konsortium, N. 577
Koo, P. 335
Kopeckova, K. 1133
Kopf, H. 667
Köpke, M. 295, 537
Kopp, Hans-G. 768, 809
Köppel, M. 955
Kopp-Schneider, A. 44
Kopyltsov, E. 74
Korbenfeld, E. 1022
Körber, S. 769, 802
Korell, F. 688
Körfer, J. 901
Körner, S. 411
Kornmann, M. 856
Kortmann, Rolf-D. 821
Koschmieder, S. 784
Köster, Marie-J. 432
Kotarac, A. 305
Kotecha, R. 674
Kotzerke, J. 986
Kouka, M. 447, 573
Kowalski, C. 408, 787, 853
Kowalski, D. 62
Koziorowski, A. 755
Kraack, Lea F. 860
Krabbe, J. 93, 99
Krabbe, Laura M. 116
Krabbe, S. 994
Kraeft, A.-L. 1055
Krafcsik, M. 816
Krat, U. 228
Kragl, B. 308
Krajsová, I. 388
Krallmann, C. 723
Krämer, A. 917, 995
Kramer, K. 12, 813
Kramer, M. 55
Krämer, S. 204
Krammer-Steiner, B. 308
Kranz, P. 282
Kratz, C. 979
Kratzer, V. 650, 786
Kraus, J. 1141
Krause, K. 1020
Kraus, T. 93, 99
Krause, F. 425, 501
Krause, Jan K. 629
Krause, M. 734, 986
Krauß, L. 559
Krawczyk, N. 917
Kraywinkel, K. 496, 629, 1130
Krebs, S. 687
Krege, S. 499
Kreissl, S. 378
Kreitz, S. 336, 1051
Krell, V. 994, 1147
Krekeler, C. 246
Kremeike, K. 557, 572
Krepper, D. 1005
Krentzke, M. 396
Kreuser, Anna L. 327
Kreutz, R. 994
Kreutzer, J. 897, 902, 962
Kreuzberg, N. 847
Kreyer, R. 954
Krieg, Sandro 1084
Krieger, J. 276
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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index272
Krieger, T. 13
Kriegmair, M. 913
Krilaviciute, A. 802
Krimm, S. 89
Krishna, A. 342
Kristensen, Vessela N. 484
Kristiansen, G. 802
Kristina, R. 764
Kröger, B. 256, 347
Kroh, B. 89
Krohn, M. 316
Kroll, L. 956
Kroll, T. 926
Krombholz, A. 975
Krolo-Wicovsky, F. 190, 843
Kron, A. 350, 544, 965
Kron, F. 350, 403, 418, 482, 525, 544
Kronawitter, U. 650
Krönke, J. 748
Kronziel, L. 145
Kropf-Sanchen, C. 636, 947
Kröplin, J. 436
Kruck, S. 913
Krueger, G. 912
Krug, D. 854
Krug, J. 657
Krug, K. 842
Krüger, M. 324
Krüger, M. 160
Krüger, R. 657
Kruger, S. 88
Krüger, S. 1058
Krull, A. 78
Kruschel, I. 833
Kruszewski, M. 620, 661
Kubasch, Anne-S. 359
Kubiak, K. 107
Kubin, Thomas W. 181
Kuchelmeister, K. 945
Kuchen, R. 518
Küchler, S. 750
Kuczyk, Markus A. 802
Kudo, M. 351, 377
Kuehn, C. 760
Kuehnel, J. 954
Kufel-Grabowska, J. 536
Kühle, R. 306, 938
Kuhlmann, L. 1086
Kühlwein, J. 1141
Kühn, A. 690
Kühn, F. 1015
Kühn, J. 620, 1147
Kühn, Jan P. 411
Kühn, M. 333, 547
Kuhn, S. 667
Kühn, T. 295, 537
Kühne, T. 825
Kühnel, S. 469, 510
Kuhnigk, K. 958
Kuhnt, S. 796
Kuhnt, T. 52
Kuiper, B. 168
Kumar, A. 567
Kümmel, S. 214, 1075
Kunadt, D. 712
Kunc, K. 632
Kunhardt von Schmidt, L. 305
Kunzke, T. 1079
Kunzmann, V. 856
Kuon, J. 689
Kupka, J. 647
Kupka, T. 782
Küpper-Nybelen, J. 56
Kurland, E. 265
Kurland, John F. 1000
Kuroda, H. 345
Kurowski, K. 724, 795, 944
Kurte, Melina S. 403, 418, 482
Kuruvilla, J. 262
Kurz, Felix T. 610, 861, 867
Kusch, M. 560
Kuss, I. 37, 74, 83
Kussel, T. 581
Kuzdzal, J. 273
Kuzinska, Matylda Z. 761
Kyte, Jon A. 484
Kyung Cho, E. 1056
L
Laack, Heinz-E. 689
Laban, S. 268, 460
Lablans, M. 581
Labohm, L. 1130
Labuhn, S. 239, 888
Lachowicz, M. 212
Laing, E. 390
Lakes, J. 298, 802
Lamanna, N. 549, 578
Lamberti, C. 1055
Lambrecht, L. 885
Lambrecht, M. 481
Lampe, B. 107
Lamrani, A. 358
Lan, L. 360
Landgraf, C. 594
Laner, A. 577, 803, 836
Lanfranconi, F. 672
Lang, K. 221
Lang, S. 704, 717
Lange, Hans C. 211, 219
Lange, M. 969
Lange, S. 514
Lange, T. 52
Langenkamp, Ulrich I. 308
Langer, C. 674
Langer, T. 747
Langer, T. 56, 145, 207, 630, 675
Langer, V. 647
Langewitz, W. 646
Langheinrich, Melanie C. 892
Langley, R. 779
Lapshyn, O. 446
Larsen, J. 334
Laryionava, K. 833, 842
Lassmann, S. 661
Latif, U. 764, 876
Lau, G. 377
Lauer, U. 595
Lavie, D. 251
Layer, K. 994
Le Tourneau, C. 301
Leal, T. 674
LeBlanc, R. 335
Lech-Maranda, E. 549, 578
Ledig, S. 275
Lee, C. 372
Lee, Dae H. 999, 1018
Lee, E. 918
Lee, Jong-S. 62, 571, 1018, 1022
Lee, Kang-Y. 345
Lee, Ki H. 571
Lee, S.-H. 1022
Lee, Sung E. 784
Lee, Y. 372, 1138
Lee-Hoeich, Si T. 251
Leha, A. 839, 897, 902, 962
Lehle, S. 484
Lehmann, J. 88, 590
Lehmann, R. 582
Lehmann-Emele, E. 195, 371
Lehmann-Laue, A. 456
Lei, G. 1075
Lei, M. 70, 273
Leibbrand, B. 564
Leichnitz, C. 632
Leinert, E. 275
Leisz, S. 123, 124, 125
Leithäuser, M. 308
Leithner, A. 825
Leitner, T. 748
Leitsmann, M. 499
Leitzmann, M. 701, 1088
Leminski, C. 557, 572
Lemke, J. 359
Lensker, P. 109
Lentz-Hommertgen, A. 769
Lenz, G. 246, 712, 947, 1054
Leplow, B. 486
Lesniak, J. 1079
Letsch, A. 828, 860, 866
Lettmaier, S. 311
Leu, M. 327
Leukel, P. 1103
Lewerenz, J. 426
Lewis, David J. 567, 578
Lewis, J. 267
Ley, M. 535
Leyerer, K. 280
Li, D. 934
Li, H. 62
Li, J. 336, 934
Li, J. 549
Li, J. 708
Li, J. 1051
Li, L. 571
Li, M. 769
Li, R. 37, 83
Liang, L. 495
Liberman, M. 1000
Lichius, K. 558
Liebau, Emma R. 154, 593
Liebscher-Koch, S. 780
Liepa, Astra M 196
Lier, M. 819
Liermann, J. 769
Liersch, P. 798
Liersch, T. 798, 897, 902, 962
Liese, J. 436
Liesfeld, B. 584
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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 273
Lièvre, A. 273
Lim, Jhin J. 682
Lim, S. M. 999
Lin, Chien-C. 336, 1051
Lin, N. 182
Lin, Y. 237, 1133
Lin, Yi-L. 821
Lindberg-Scharf, P. 428
Linde, P. 754
Lindenberg, T. 862
Lindenmayer, J. 531, 1141
Lindner, K. 468
Linge, A. 734
Lingenhöl, F. 491
Lingohr, P. 304
Link, T. 323
Linke, B. 432
Linnebacher, M. 316
Linxweiler, M. 411
Linz, Valerie C. 154, 183, 290, 593
Lipka, K. 271
Lipke, J. 966
Lipp, R. 181, 745
Lisberg, A. 360, 989
Liste Hermoso, M. 175
Liszkay, G. 388
Liu, B. 567, 1022
Liu, C. 360
Liu, H. 578
Liu, S. 62
Liu, T. 70
Liu, Y. 251
Lo Russo, G. 999
Lobmann, R. 187
Lobo, J. 1124
Locher, M. 577
Löck, S. 986
Lodes, U. 550
Loertzer, H. 1124
Loes, K. 767
Löer, M. 316
Loges, S. 352, 514
Lohaus, F. 986
Lohmüller, L. 256, 347
Lohneis, P. 88
Löhr, P. 698
Lohse, S. 1124
Loi, S. 1075
Loibl, S. 214, 1053, 1075
Lonardi, S. 502
Loong, H. 1108
Lopez, N. 251
López-Pleguezuelos, C. 481
Loquai, C. 388
Lordick, F. 492, 901
Lorenz, R. 1040
Lorenzato, A. 305
Lorenzen, S. 492
Lorusso, D. 270
Losa, F. 995
Löser, H. 88
Loskutov, J. 682
Losonczy, G. 62
Lotz, B. 283
Lotz, J. 834, 839
Lu, S. 1022
Lubig, S. 96, 744
Lucas, M. 803, 836
Lucia, A. 672
Lucius, H. 20
Lüdecke, R. 1026
Lüdecke, G. 1026
Lüdtke-Heckenkamp, K. 875
Ludwig, Jan O. 296
Lugnier, C. 1055
Lühnen, J. 786
Lukac, S. 1122
Lüke, F. 673, 781
Luna, J. 656
Lüpkes, C. 56
Lüth, F. 419
Lutz, M. 656
Lutz, Manfred P. 856
Lutz, R. 933, 939, 942, 950
Lux, Michael P. 445
Lux, S. 952
Luz, M. 265
Lymp, J. 262
M
Ma, S. 549, 567, 578
Maass, N. 191
Maatouk, I. 77, 127
Machtens, S. 181
Maciag, P. 335
Mackensen, A. 20
Maddocks, Kami J. 567
Madhira, V. 260
Madl, B. 1088
Maeda, P. 1133
Magee, Derek R 767
Magheli, A. 409
Mahgull, M. 388
Mahlberg, M. 796
Mahler, C. 17, 256, 347, 813
Mahn, R. 304
Mahner, S. 151
Mai, K. 994
Maier, D. 581
Maisch, P. 913
Majchrzak-Stiller, B. 770, 776
Mak, M. 1108
Makowsky, M. 351, 370, 377
Malt, A. 305
Malter, W. 536, 760, 946
Mamounas, E. 1053
Manapov, F. 415
Mańczak, A. 304
Mandalà, M. 388
Mandic, R. 325
Mandlmeier, F. 468
Manettas, A. 143
Mangum, C. 283
Manier, S. 43, 237, 334, 1060
Manjunath, A. 468
Mann, B. 536
Mann, H. 345, 1000
Mano, M. 1053
Mansmann, U. 858
Mantke, R. 892
Manz, K. 410, 453, 984
Mao, W. 1018
March, C. 517, 619, 621
Marcovitz, M. 370
Marella, N. 578
Margraf, C. 990
Maria Barbui, A. 262
Marienfeld, R. 732
Maringa, M. 275
Märkl, B. 698, 779
Markus, F. 700
Marmor, Y. 260
Marquard, S. 896, 930
Marquardt, Jens U. 675
Marschall, U. 56
Marschner, N. 49
Marsden, D. 342
Marten-Mittag, B. 1146
Martens, J. 902, 962
Martens, Uwe M. 278, 301
Martin, S. 378
Martín, M. 196, 423, 762, 1085
Martinez, M. 1022
Martus, P. 813
Mascaux, C. 989
Masi, G. 370
Maßmann, A. 839
Mateos, Maria-V. 237, 334
Materna, L. 100
Mateska, I. 734
Mathas, S. 378
Matheny, S. 214
Mathies, V. 663
Mathis, M. 661
Matschke, J. 311
Mattarei, J. 399
Mattheis, S. 704, 717
Matthes, H. 48, 51, 632
Matthes, M. 759
Matuschek, C. 854
Matveev, V. 1124
Mauch, C. 847
Mauch, H. 17
Maurer, A. 521
Maurer, J. 326, 845
Maurer, L. 994
Mäurer, M. 52, 134, 358
Mausbach, A. 116
May, A. 212, 536
May, Claus J. 324
Mayer, B. 91, 838
Mayer, B. 816
Mayer, K. 1020
Mayer-Steinacker, R. 732
Mayr, A. 80
Mayr, C. 493
Maywald, U. 276
McCoon, P. 372
McIntyre, K. 196
McKinney, M. 578
McKiver, Mihaela P. 1060
McLornan, D. 784
Medenwald, D. 52, 134, 164, 513, 517, 621
Medlin, J. 828
Meesters, S. 557, 572
Mehlhorn, G. 355
Mehlis, K. 663, 777, 842
Mehlitz, M. 518
Mehmeti, F. 402, 810
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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index274
Mehnert-Theuerkauf, A. 456, 796, 874, 1148
Meier, I. 56
Meier, K. 435, 751
Meier, S. 878
Meier-Rosar, F. 901
Meier-Stiegen, F. 917
Meinert, Fabian M. 994
Meisel, C. 275
Meißner, C. 721
Meissner, J. 318, 378
Meißner, W. 325
Meister, L. 866
Meixensberger, J. 518
Mekan, S. 1056
Mela, P. 838
Melchior, F. 793
Melekian, B. 107
Melhem, A. 363, 792
Melzer, M. 1122, 1138
Melzner, A. 271
Memenga, P. 594
Menck, K. 246
Mendes Wefelnberg, M. 923, 932
Mendez, G. 273
Meng, K. 444
Mennig, E. 187
Menold, N. 663
Menrath, I. 630, 675
Mercan, S. 764, 876
Mercier, D. 462
Mergel, F. 402, 810
Mergenthal, K. 1037
Merkelbach-Bruse, S. 521, 716, 736, 774,
778, 893, 1136
Merker, K. 984
Merta, J. 854
Merz, M. 308
Merzenich, H. 56
Mesa, R. 784
Messer, Sarah L. 391
Method, M. 270
Metz, A. 295
Metz, C. 35
Metzeler, Klaus H. 359
Metzenmacher, M. 511, 574, 756, 1070
Metzger, P. 661
Metzger, R. 856
Metzler, M. 109
Meyer, B. 452, 506, 1084
Meyer, C. 346
Meyer, F. 517, 542, 550, 591, 597,
619, 621, 765, 940, 954
Meyer, M. 704, 717
Meyer-Feil, T. 878
Meyers, O. 576
Meyer-Wilmes, P. 107
Michaelis, S. 207
Michaelis, S. 946
Michaud, C. 995
Michel, Maurice-S. 499
Michl, P. 634
Michlíková, S. 734
Mielke, S. 262
Miething, C. 620, 661
Migliorino, Maria R. 1018
Mihaljevic, A. 595
Mihm, S. 427
Miinalainen, I. 926
Mijatovic, M. 873
Milani, V. 151
Milanowski, J. 674
Mildenberger, V. 350, 544
Mileshkin, L. 995
Milke, V. 557, 572
Milsom, M. 952
Milzer, M. 77, 127
Mingchao, X. 1074
Mink, J. 1124
Miranda, M. 343
Miranda, P. 260
Mirow, L. 253
Mirwald, M. 729, 1143
Misch, M. 396, 518, 1143
Misiak, D. 186
Mispelbaum, R. 875
Mitchell, R. 723
Mitschke, S. 1129
Mitsudomi, T. 345
Mittendorf, E. 175
Mix, M. 890
Mizutani, H. 571
Moccia, A. 378, 589
Mocek, A. 984
Moch, H. 995
Mock, A. 332, 449
Modest, Dominik P. 188
Moeller, R. 186
Moench, K. 462
Mohamed, A. 37
Mohammad, F. 149
Mohammad Nejad Farid, K. 771
Mohammed Abdou, M. 657
Möhler, M. 70, 140, 273, 367, 1000
Mohm, J. 966
Mohr, M. 947
Mohr, R. 582
Möhring, C. 304
Moka, Prof. Dr. D. 756
Molena, D. 1000
Molinero, L. 175
Moll, M. 932
Moll, M. 419
Möller, L. 95, 233, 848, 882
Momeni, S. 667
Mongondry, R. 672
Monin, Malte B. 304
Monin, R. 702
Monninkhof, Evelyn M. 536
Monroy Ordonez, Elsa B. 880
Moon, K. 965
Moore, K. 270
Moraitis, A. 228
Morakis, P. 504
Moratin, J. 306, 938
Moreau, P. 237, 334, 1060
Morgans, A. 94
Morkel, M. 305
Morlok, D. 1088
Morlot, S. 275
Morouj, B. 984
Morris, S. 62
Morschhauser, F. 262
Mörtl, B. 656
Mößner, U. 1090
Motoyama, S. 273
Mourão, J. 1022
Mozaari, E. 384, 918
Mpofu, P. 455
MTB-FR Network 620, 661
Mück, C. 990
Muegge, Lars-O. 308
Muenst, S. 605, 612
Mühlberg, R. 35, 208, 247
Mühle, C. 906
Mühler, M. 1049, 1134
Mühling, B. 636
Müller, A. 447
Müller, E. 385
Müller, F. 20
Müller, H. 318
Müller, J. 536, 715
Müller, Jörg-A. 52, 164, 1011
Müller, L. 492
Müller, M. 385
Müller, S. 758, 808
Müller, T. 770, 776
Müller, V. 49, 402, 810
Müller, V. 1040
Müller-Huesmann, H. 689
Müller-Tidow, C. 688, 771, 911
Mumm, F. 650, 786, 877, 990, 1071
Mummey, H. 1138
Munir, T. 278, 549, 567, 578
Munoz-Fernandez, M. 1085
Munzert, F. 956
Muro, K. 1000
Muth, C. 687
N
Na, Il-K. 1136
Nabet, B. 62
Nachbar, M. 551
Nacke, N. 1054
Nadji-Ohl, M. 518
Nadolny, S. 634
Nagai, H. 567
Nagai, J. 1076
Nagel, G. 268
Nair, B. 578
Nakamura, Y. 818
Nankivell, M. 779
Narosch, J. 128
Naschberger, E. 79, 657
Naser, S. 429
Nasroulah, F. 1057
Nasseh, D. 650
Nasta, Sunita D. 549, 567
Nastoupil, Loretta J. 262
Nathani, R. 140
Nauck, F. 371
Nazaré, M. 267
Necchi, A. 1057
Neemann, F. 255
Ne, A. 325
Negro, A. 351, 370, 377
Negwer, C. 1084
Neitzel, B. 577
Nekolla, E. 135
Nelson, N. 349
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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 275
Neppl, S. 358
Nerger, K. 186
Nestle, U. 705
Nestler, T. 906
Nettekoven, C. 742
Nettekoven, G. 629
Neu, Marie A. 333, 547, 672
Neubauer, H. 862, 864, 917
Neubauer, M. 994
Neuberger, M. 906
Neuberger, S. 100, 906
Neuhann, T. 577, 584
Neuhaus, N. 723
Neumaier, S. 187, 809
Neumann, A. 207
Neumann, C. 645, 649, 690, 735
Neumann, F. 712
Neumann, M. 558
Neumayer, B. 493
Neumeyer, S. 357
Neumuth, T. 615
Neureiter, D. 493
Neureiter, E. 493
Neven, P. 1085
Ngo, Q. 52
Nguyen, B. 567
Nickelsen, M. 1054
Nicolay, Nils H. 235, 705
Niederacher, D. 862, 864, 917
Niedermaier, T. 585
Niedermeier, M. 188
Niederreiter, M. 838
Niederwieser, D. 76
Niegisch, G. 276
Nieland, S. 425
Niels, T. 638, 807
Nietert, M. 834
Nikolova, Z. 251
Nilius, G. 755, 756
Nishii, R. 262
Nishio, M. 571, 1018
Nkenke, E. 951
Noack, B. 256, 347
Nobbe, K. 96
Noeding, S. 49
Nogai, A. 748
Noh, Ka-W. 914
Nooka, Ajay K. 1060
Nordho, V. 655
Norris, R. 984
Nöthling, C. 724
Novak, U. 378
Novello, S. 1108, 1131
Novosiadly, R. 273
Nozaki, K. 260
Nusch, A. 49
Nyawira, B. 1053
O
Ober, A. 107
Oberste, M. 1064
O’Byrne, K. 571
Ochi Lohmann, T. 1018
Ochsenreither, S. 332, 449
Ocio, Enrique M. 335
Ockert-Schön, F. 751
Odenthal, M. 934
Odin, V. 15
O’Donnell, S. 711
Oechsle, K. 221, 406, 557, 569, 572,
637, 733, 737, 738
Oehme, I. 44
Oei, Shiao L. 48, 51
Oelmann, J. 327
Oeltze-Jafra, S. 782
Oertel, M. 52, 134, 1054
Oeser, A. 391
Oestreich, L. 786
Oetting-Roß, C. 613
Oh, Do-Y. 66, 372, 375, 708, 1000
Oh, S. 784
Oh, Sang C. 708
Ohmura, S. 1120
Ohnmacht, C. 662
Okamoto, I. 989
Okech, T. 4
Oldenburg, J. 1057
Oldsen, R. 185
Oliinyk, D. 901
Omari, J. 591
Omori, T. 1000
Omran, A. 267
On Behalf of the TARGET-Study
Group 650, 786
ONeill, C. 149
Onken, Julia S. 376, 396, 518, 1143
Opalka, B. 712
Opitz, B. 188
Orawa, H. 458
Oriol, A. 335
Ormanns, S. 88
Ortega, Juan Luis R. 262
Ortega Granados, Ana L. 576, 999
Ortiz-Brüchle, N. 239, 521
Ortmann, O. 629, 710
Ortmüller, F. 547
O‘Shaughnessy, J. 214, 423, 1085
Osowski, U. 181, 276, 745
Ossowski, S. 1073, 1095
Ostapenko, Y. 377, 1022
Osterborg, A. 549
Ostermann, H. 352
Ostwal, V. 708
O‘Sullivan, C. 762
Osumi, H. 305
Ott, A. 1073
Ott, S. 1090
Otte, N. 99
Otto, R. 550, 721, 954
Oubaid, N. 557, 572
Ourailidis, I. 598, 851
Overbeck, T. 700, 947
Overlach, A. 247
Ozguroglu, M. 995
P
Paasch, C. 765, 892
Pabst, T. 237, 334, 1060
Paepke, S. 468
Paenholz, P. 55, 100, 906
Pagel, Charlotta F. 327
Palmer, J. 784
Palomba, M. L. 262
Palti, Y. 702
Panchal, S. 1015
Panikkar, R. 674
Panse, J. 467, 1089
Pantel, K. 402, 810, 917, 1040
Pantelis, D. 1015
Paolini, S. 336, 1051
Pappesch, R. 736, 778
Papuga, J. 262
Paradies, K. 151
Pardo, L. 977
Park, Joon O. 66, 375, 426
Park, Joong-W. 351
Park, K. 1108
Passamonti, F. 540, 784
Patel, B. 540
Patel, K. 43, 237, 334, 1060
Patel, K. 260, 278, 549, 567
Patel, Manisha R. 549, 578
Patient Advisory Board (SDGC) 53
Patil, D. 793
Patnana, Pradeep K. 712
Pauer, A. 414
Pauge, S. 663
Paul, Norbert W. 672
Paulenz, I. 308
Pauli, B. 535
Pauli, C. 995
Pauli, T. 661
Pavel, M. 1020
Payakachat, N. 1131
Paz-Ares, L. 360, 571, 989
Pazo-Cid, R. 995
Peeken, J. 1084
Peipp, M. 800
Pekar, L. 800
Pelaez Puente, M. 212, 536
Pelusi, N. 965
Pelz, H. 492
Pelzer, U. 645, 649, 690, 708, 735
Peraud, A. 806
Pérez, E. 291
Perkhofer, L. 188, 531, 856, 884,
1138, 1141
Perkins, A. 784
Pérol, M. 360, 989, 1108
Perrakis, A. 619
Perrot, A. 237, 335
Persigehl, T. 590, 847
Persin, S. 599
Perualila, Nolen J. 697
Peschel, C. 468
Peters, S. 999
Petermann-Meyer, A. 467
Peters, I. 770, 776
Peters, S. 571
Petersen, C. 75
Peterson, J. 911
Peterziel, H. 44
Petridis, F. 878
Petrova, M. 375
Petru, E. 191
Petruzelka, L. 674
Petzold, A. 355
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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index276
Peukert, R. 396
Pfante, O. 462
Pfarr, N. 468
Pfau, G. 940
Pfeer, S. 20
Pster, K. 402, 810
Pster, R. 946
Pfohl, U. 682
Piasecki, J. 43, 237, 334, 1060
Pichler, T. 786
Picht, T. 376
Picker, N. 656
Pickl, Julia MA. 584, 858
Picmanova, V. 672
Piessen, G. 273
Pietsch, T. 363, 792
Pietzner, K. 107, 450
Pigerl, M. 710
Pilarsky, C. 20, 653
Pilz, M. 1011
Pink, D. 686
Pirmorady, A. 994
Piscuoglio, S. 609
Pittrich, P. 814
Piwonski, I. 332, 449
Plachky, P. 211, 635
Planchard, D. 360
Platzbecker, U. 76, 336, 359, 540,
676, 1051
Pless, M. 674
Ploch, L. 333, 672
Ploeger, B. 83
Plönes, T. 574
Pluzanski, A. 571
Pochert, N. 295, 537
Poddubskaya, E. 989
Poeller, P. 1120
Poeschel, V. 1054
Poeser, P. 396
Pogoda, K. 1011
Pogoda, M. 1073
Pogorzelski, M. 875
Pöhlmann, B. 499
Pollastri, F. 1079
Polli, A. 388
Polzer, B. 917
Pongratanakul, P. 1012
Pons Tostivint, E. 360, 989
Poon, P. 774
Popova, V. 829
Popp, F. 88, 934
Popp, I. 719, 729
Porst, J. 994, 1147
Porta, Matteo G. 336, 1051
Porzelle, J. 634
Pospiech, H. 926
Potemski, P. 708
Pöttgen, C. 511
Pottho, Anna-L. 363, 792, 945
Powles, T. 1057
Pozharskaya, V. 336, 1051
Pozzo, E. 729
Pralong, A. 535, 740
Prange-krex, G. 308
Prat, A. 484
Prebet, T. 1051
Predel, Hans-G. 946
Pregler, Barbara E. F. 363, 792
Pretzell, I. 514
Preugszat, E. 88
Primus, H. 707
Printzen, S. 638
Pro, L. 247
Protzel, C. 499
Pryalukhin, A. 1124
Ptok, H. 550
Puig, Juan M. 999
Pukrop, T. 433, 673, 701, 781
Püllen, L. 228, 455
Pulst Caliman, Tilman J. 1147
Punie, K. 175
Purcea, D. 1057
Puri, T. 1108
Püschel, K. 738
Putora, Paul M. 528
Putzker, K. 267
Puzik, A. 35, 207, 240, 662
Q
Qin, S. 66, 372
Quaas, A. 88, 716, 847, 904, 1136
R
Raab, M. 949
Raab, Marc S. 43, 334, 335
Rabe, A. 170
Rack, B. 402, 732, 810, 1040
Radbruch, H. 396
Radlanski, K. 319
Radosa, J. 49, 107
Raepple, S. 710
Rael, J. 838
Raghav, K. 818
Raiber, L. 12
Raje, N. 237, 334, 335, 1060
Ramage, J. 1011
Ramalingam, Suresh S. 571
Raman, I. 251
Ramlau, R. 674
Ramming, A. 79
Ramos, J. 818
Ramsenthaler, C. 670
Ran, D. 351
Ran, W. 1085
Rancati, T. 481
Randerath, W. 1136
Randrian, V. 502
Rank, A. 589, 698
Rapp, D. 426
Rapp, M. 518
Rasche, L. 583, 748
Rashid, Masturah Mohd A. 682
Raspe, M. 396
Rastogi, P. 423, 1085
Rath, M. 275
Ratjen, I. 828, 860, 866
Rattay, T. 481
Rau, B. 761
Rau, Kun-M. 708
Rau, T. 888
Rauber, S. 79
Rawluk, J. 875
Read, Stephanie H. 384
Real, C. 298
Reber, C. 612
Recher, C. 540
Reck, M. 62, 345, 571, 576, 999, 1056
Recker, F. 452, 506
Reckermann, L. 819
Redaèlli, M. 899
Redler, S. 888
Reents, N. 979
Regenbrecht, C. 653, 682
Regincos, P. 187
Regnery, S. 306, 938
Rehling, P. 764
Rehlinghaus, M. 100, 906
Reich, F. 274
Reichard, C. 819
Reichel, M. 926
Reichert, C. 782
Reichert, M. 906
Reichert, M. 650
Reif, M. 632
Reig, M. 351, 370, 377
Reiger, M. 295, 537
Reimer, A. 535
Reinacher-Schick, A. 514, 856, 1055
Reiner, M. 769
Reinhard, C. 653, 682
Reinhardt, C. 418
Reinhardt, D. 431, 916
Reinhardt, F. 862
Reinhold, T. 994
Reinisch, M. 1085
Reinmuth, N. 360, 989, 1056, 1131
Reis, A. 979
Reis, H. 95, 228
Reismann, D. 622
Reißfelder, C. 1015
Reitnauer, L. 947
Reitsam, N. 779
Reitsma, H. 168
Reitz, M. 1088
Relógio, A. 349
Renard, C. 722
Renovanz, M. 518
Rentsch, M. 858
Renz, Bernard W. 1015
Reppenhagen, Jil-C. 436
Resheq, Yazid J. 531, 1141
Restuccia, E. 1053
Reuten, R. 741
Reuter, H. 874
Reutlinger, K. 876
Reyes Cabanillas, R. 1056
Rezazadeh Kalebasty, A. 74, 83
Rhein, S. 871
Rhiem, K. 275, 280
Rhoades, Joanna M. 549
Rhodes, J. 567, 578
Ribrag, V. 251
Richardson, G. 536
Richardson, Paul G. 335
Richartz, V. 893
Richlitzki, C. 511, 1070
Richter, F. 145, 675
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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 277
Richter, L. 663
Richter, M. 634
Richter, P. 250
Richter, Ricarda-C. 274
Rick, O. 327
Ricken, T. 1140
Riders, A. 1064
Ridwelski, K. 721
Riedel, F. 452, 506
Riedel, M. 450, 452, 506
Riedlsperger, M. 1049
Rieger, D. 518
Rieke, D. 332, 449, 965
Rieken, S. 327
Ries, J. 933, 939, 942, 950, 951
Ries, V. 1137
Riesch, S. 650
Rieser, T. 48, 51
Riess, O. 1073, 1095
Riethdorf, S. 917
Rimassa, L. 377
Rinderknecht, E. 55
Rink, A. 417
Riou, A. 526
Ripperger, T. 275, 979
Ristau, J. 769
Ristau, P. 613
Ritter, J. 275, 364
Ritter, T. 962
Ritter, V. 452
Ritter-Vanoorop, T. 897, 902
Ritz, A. 675
Rivandi, M. 862, 917
Rizvi, K. 672
Rizzo, C. 750
Robers, G. 410, 453
Robert, C. 388
Robertson, A. 433
Robinson, B. 1133
Roch, C. 385
Röcken, C. 446, 1058
Röderer, N. 667
Rodriguez, C. 335
Rodriguez Canales, J. 1074
Rodríguez-Otero, P. 43, 237, 334, 1060
Roeker, Lindsey E. 549, 567, 578
Roeper, J. 685, 700
Roessner, A. 757, 844
Rogahn, J. 424
Roger, E. 1138, 1141
Roggia, C. 1095
Roick, J. 634
Roig-Merino, A. 911
Rokohl, A. 923, 932
Rokutanda, N. 66, 372, 375, 708
Rolfo, C. 674
Roll, S. 994
Romic-Pickl, J. 803, 836
Ronellentsch, M. 518
Roohani, S. 52, 291, 368, 729
Roohani, Soleiman F. 729
Roos, J. 260, 343
Roos, J. 393
Rosas Romero, Juan C. 481
Rose, M. 184
Rose, M. 994
Rose, S. 336, 1051
Rösel, I. 813
Rosenau, H. 634
Rosenberger, F. 715, 812
Rosenbrock, J. 754
Rosenbusch, Marie-L. 853
Rösener, J. 1081
Rosenstein, Barry S. 481
Rosentreter, J. 435, 751
Rosenwald, A. 378
Ross, J. 995
Rössle, S. 809
Rossner, Anna-M. 450
Rotermund, T. 729
Roth, Katrin S. 754
Roth, W. 1129
Rothe, A. 966
Rothe, T. 750
Roth-Goldbrunner, S. 742
Rotmann, A. 855
Röttger, A. 630
Roubec, J. 674
Royce, T. 455
Ruane, S. 1136
Rübe, C. 1054
Rübner, M. 484, 624, 1040
Rückert, Jens-C, 1136
Ruckes, C. 672
Rudack, C. 1064
Rudlowski, C. 96, 744
Rudolph, H. 253
Rudolph, I. 707
Ruf, T. 1018
Ru, L. 1136
Rugo, Hope S. 214, 423, 1085
Ruhe, S. 458
Rühle, A. 311, 235, 358
Ruhnke, M. 181
Ruhnke, T. 56
Rundqvist, H. 536
Runnebaum, Ingo B. 355, 956, 958
Rupp, I. 990
Rupp, R. 758, 808
Ruppert, Amy S. 549, 567, 578
Russo, M. 305
Rüter, G. 745
Rütjes, A. 560
S
S. Abramson, J. 262
Saad, F. 37, 74, 83
Saadat Sarmadi, S. 283
Saavedra, H. 682
Sade, H. 1074
Sade, Juan P. 1057
Sadeghlar, F. 304
Safavi, F. 1056
Sagasser, J. 107, 537
Sahm, F. 1084
Saji, S. 175
Salcher, S. 315
Salchow, J. 35, 240
Salinas, G. 876
Salm, S. 1037
Salmen, J. 444
Salomo, S. 128, 213
Salzmann, N. 35, 240
Samland, L. 35, 247
San Antonio, B. 196, 1085
San Lucas Zambrano, Jennifer S. 325
Sanchez-Ibarra, Hector E. 267
Sander, A. 35, 240
Sandhu, I. 335
Sandrini, E. 769
Sands, J. 360, 989
Sangha, R. 571
Sangro, B. 351, 377
Sanhaji, M. 949
Sankarasubramanian, S. 653
Sannai, M. 926
Santarpia, L. 762
Santel, A. 720
Santini, F. 1108
Santini, V. 336, 1051
Sappok, T. 853
Saran, S. 1074
Sargin, B. 1055
Sarria, G. 304
Satoh, T. 502
Satore-Bianchi, A. 502
Satragno, C. 729
Sauer, C. 659
Sauer, S. 911
Sauer, T. 688, 771, 911
Sauerbrunn, N. 558
Saura, C. 1075
Scafa, D. 52
Scartoni, S. 182, 214
Schaaf, M. 188
Schablack, A. 239
Schad, F. 48, 51, 393, 827
Schadendorf, D. 388
Schäfer, C. 1112
Schäfer, Fritz K.W. 1058
Schäfer, H. 880
Schäfer, K. 486
Schäfer, Karl-L. 888
Schäfer, N. 1015
Schäfer, S. 1146
Schäeler, N. 390
Schäer, H. 402, 810, 931
Scharath, N. 501
Scharin, V. 838
Scharin-Nabe, D. 622
Schäfsmeier, L. 738
Schäker-Hübner, L. 901
Schallenberg, S. 1136
Schanz, J. 798, 962
Schanze, D. 584
Schaper, T. 515
Schardey, J. 1015
Scharf, F. 803, 836, 858
Scharl, M. 657
Scharl, S. 816
Scharnweber, A. 675
Schaser, J. 831
Schatz, S. 417
Schatz, S. 660
Schaub, V. 378
Scheele, J. 462
Scheer, M. 123, 124, 125
Scheer, M. 239, 893, 965
Scheold, K. 692
Downloaded from http://karger.com/ort/article-pdf/47/Suppl. 1/7/4169504/000535363.pdf by guest on 05 March 2024
Oncol Res Treat 2024;47(suppl 1):7–283 Author Index278
Scheibenbogen, C. 994
Scheid, C. 237, 334, 540, 697, 1060
Scheller, C. 123, 124, 125
Schellerer, Vera S. 79
Schenk, M. 615
Schenker, H. 1086
Schenker, M. 571, 999, 1057
Schepers, C. 535
Schepper, F. 720
Scherbring, S. 355
Scheungraber, C. 355
Schick, B. 411
Schick, M. 1074, 1079
Schiebeck, L. 456
Schieferdecker, A. 557, 572
Schiele, S. 779
Schiewer, V. 560, 687
Schier, E. 433
Schimann, L. 35
Schiner, Conrad-J. 542
Schildberg, C. 765
Schildhauer, P. 123, 124
Schildmann, J. 634, 777, 842
Schilling, B. 561
Schilling, G. 491, 565
Schilling, Merle N. 215
Schilling, O. 446
Schillinger, G. 965
Schimanski, Carl C. 856
Schimanski, S. 583
Schimmöller, L. 802
Schindler, V. 809
Schinköthe, T. 151
Schinwald, N. 455
Schirghuber, E. 301
Schirmacher, P. 598, 851
Schlaak, M. 396
Schlachtenberger, G. 1136
Schlack, K. 55, 100, 116, 181, 906
Schlageter, E. 1055
Schlatt, S. 723
Schlensog, M. 888
Schlichtig, K. 22, 80, 109
Schliephake, H. 503, 977
Schlosser, A. 316
Schlößer, Hans A. 88, 590, 754
Schlüfter, C. 667
Schlüter, K. 812
Schmalenberg, H. 308
Schmallfeldt, B. 450
Schmeer, R. 1019
Schmid, B. 79
Schmid, L. 828
Schmid, M. 1071
Schmid, P. 1075
Schmid, Y. 1122
Schmidt, Christian A. 800
Schmidt, G. 1074, 1079
Schmidt, H. 630
Schmidt, H. 1011
Schmidt, M. 61, 154, 183, 290, 593
Schmidt, M. 77, 127, 210, 536, 955
Schmidt, N. 605
Schmidt, S. 660
Schmidt, S. 324
Schmidt, T. 526, 860, 1088
Schmidt-Graf, F. 518
Schmidt-Hegemann, Nina-S. 705
Schmidt-Hieber, M. 308
Schmitt, A. 17, 256, 347
Schmitt, A. 688, 771
Schmitt, Andreas M. 612
Schmitt, J. 581, 686
Schmitt, M. 688, 771, 911
Schmitter, C. 358
Schmitz, M. 355, 573
Schmitz, N. 1054
Schmitz, S. 181
Schmoor, C. 741
Schmutzler, Rita K. 275, 280
Schnabel, A. 385
Schnabel, F. 359
Schnabel, M. 55
Schnee, M. 841
Schneeweiss, A. 1040
Schneider, C. 559
Schneider, E. 560, 696
Schneider, F. 537
Schneider, F. 735
Schneider, G. 378, 589
Schneider, G. 559, 865
Schneider, J. 812
Schneider, M. 295, 537
Schneider, M. 363, 792, 945
Schnelzer, A. 107
Schnoor, M. 675
Schoenhals, S. 724
Schoer, O. 581
Schöski, O. 650
Scholl, I. 221, 379
Scholl, S. 589
Scholz, C. 594
Scholz, C. 308
Scholz, N. 550
Schomäcker, K. 754
Schömig-Markiefka, B. 716
Schön, Anna P. 786
Schönberg, M. 1071
Schöne, N. 246
Schönfelder, R. 868, 919, 922
Schönlein, M. 247
Schöpe, Paul C. 267
Schörner, S. 158
Schrader, Andres J. 116
Schrader, J. 1020
Schrader, M. 499
Schran, S. 88
Schranz, M. 212, 518, 878
Schreier, J. 757, 844
Schreyer, K. 1146
Schrickel, J. 4
Schröck, E. 594, 979
Schröder, A. 311
Schröder, J. 275, 868, 919, 922
Schröder, M. 154
Schröder, M. 424
Schröder, W. 693, 754
Schroeder, C. 275, 979, 1073, 1095
Schröer, S. 1137
Schroers, R. 589
Schrof, S. 551
Schröter, P. 306, 938
Schubert, Maria-L. 688
Schuhbaur, Jasmin S. 504, 856
Schuit, E. 168
Schulat, C. 697
Schuler, M. 686
Schuler, M. 511, 965, 1022, 1070
Schuler, P. 460
Schüler, P. 897
Schüller, U. 729
Schulte, C. 181
Schulte, T. 1148
Schulte-Hürmann, H. 565
Schulz, A. 55
Schulz, H. 557, 569, 572, 692
Schulz, M. 853
Schulz, M. 429
Schulz, M. 1129
Schulz, S. 219
Schulz, V. 693
Schulze, A. 1120
Schulze, Arik B. 246
Schulze, Lara-M. 153
Schulze, S. 153, 186, 308, 424, 1089
Schumacher-Wulf, E. 49
Schumann, C. 345, 689
Schumann, L. 1130
Schupp, L. 720
Schürger, N. 95
Schürmann, Elisa K. 864
Schürmann, M. 780
Schuss, P. 945
Schuster, S. 35, 207, 240
Schuster, S. 622, 793
Schütte, W. 62, 947
Schütz, E. 700
Schütz, J. 504, 856
Schütz, L. 160
Schutzman, J. 1075
Schüürhuis, S. 283, 408
Schwab, J. 1122, 1141
Schwab, R. 154
Schwäble Santamaria, A. 433
Schwanfelder, J. 80
Schwarz, F. 831
Schwarz, M. 186
Schwarz, S. 316
Schwarzenbach, C. 1103
Schwarzer, A. 308
Schweizer, L. 368
Schwind, S. 76
Schwitlick, C. 828
Sebastian, M. 947, 965
Sebens, S. 446
Sedlaczek, P. 605, 609, 612, 614
Seeger, A. 154
Seelemeyer, F. 778
Seeling, C. 732
Segerer, F. 1074
Sehouli, J. 107, 450, 994
Seibold, P. 481, 644, 802
Seidel, C. 235
Seidlitz, T. 590
Seidl-Rathkopf, K. 455
Seifart, U. 797
Seitz, F. 673
Seitz, K. 624
Seitz, S. 710
Seitzer, K. 116
Seiz, W. 462
Downloaded from http://karger.com/ort/article-pdf/47/Suppl. 1/7/4169504/000535363.pdf by guest on 05 March 2024
Oncol Res Treat 2024;47(suppl 1):7–283Author Index 279
Seliger-Behme, C. 659
Seluzhytsky, A. 342
Sender, A. 456
Senft, C. 831
Senger, C. 551
Senkus, E. 536, 1085
Seo, Jae H. 196
Seog Kim, W. 567
Serpa, M. 750
Serrano, M. J. 524
Sers, C. 305
Sethi, S. 1022
setyono, E. 862
Seuerlein, T. 188, 504, 531, 629, 732,
853, 856, 884, 1122, 1141
Seuthe, K. 847
Seymour, John F. 549, 567, 578
Sezer, E. 708
Shacham Abulaa, A. 251
Shah, Nirav N. 549, 567, 578
Shah, R. 342
Shah, R. 1018
Shahir, A. 423, 1085
Shakar, N. 1075
Shaked, Z. 376, 396
Sharman, J. 278
Shearer-Kang, E. 175
Shelman, W. 502
Shen, L. 70
Shen, Q. 576
Sherman, E. 1133
Shetty, Jeevan K. 336
Shetty, V. 343
Shitara, K. 70, 367
Shiu, Kai-K. 995
Shore, N. 74, 94, 265
Shortt, J. 336, 1051
Shreeve, M. 1022
Shum, E. 360
Shumilov, E. 748
Sibert, Nora T. 853
Sichler, A. 694
Sicking, A. 917
Siddiqui, A. 1053
Siddiqui, M. 62
Siebels, M. 499
Siebenhüner, E. 994
Siebert, A. 865
Siebert, R. 732, 979
Siebert, U. 1049, 1134
Siebolts, U. 239, 736, 774, 778
Siefen, Ann-C. 403, 418, 482, 525
Siegle, A. 296
Siegmann, A. 816
Siemanowski, J. 716, 736, 774
Siena, S. 818
Siepmann, K. 590
Sievert, M. 758, 808
Sigle, A. 890
Silberg, M. 100
Silcher, C. 255
Simic, D. 350, 544
Simmins, Juan Pablo V. 462
Simon, F. 1064
Simon, J. 208
Simon, P. 333
Simon, Steen T. 535, 740
Sindern, J. 697
Singer, S. 518, 686, 878
Singh, N. 959, 960, 961
Singhal, S. 43
Sinn, M. 35, 188, 207, 240, 247
Sipos, B. 595
Sirachainan, E. 708
Sirhan, S. 540
Skarbnik, A. 278, 343
Skatkova, O. 301
Skoczylas, T. 70
Skoetz, N. 391
Slawska, J. 468
Smakal, M. 61
Smirnow, I. 595
Smith, J. 267
Smith, M. 37, 74, 83
Smith, Victoria M. 817
Smuda, A. 819
Sobrero, Alberto F. 502
Söhl, Malte F. 828
Söhlke, B. 352
Sohm, M. 188
Sohn, Joo H. 175, 762
Soinski, N. 526
Sokalska-Duhme, M. 35, 240
Sokotukhin, V. 414
Solbach, C. 275
Soldatenkova, V. 1108
Sölder, P. 385
Soleymani, S. 70
Söllner, W. 646
Solomon, B. 1018, 1108
Solomon, Scott R. 237, 334, 1060
Sommer, C. 1103
Sommer, G. 759
Sommer, M. 208
Sommer, N. 304
Sommerlatte, S. 777
Song, C. 1075
Sonke, G. 536
Sonntag, B. 646
Sonntag, M. 268, 460
Sonpavde, G. 1057
Soo Tiong, I. 336, 1051
Sookprasert, A. 375
Sookthai, D. 188
Sorg, B. 825
Sowa-Israel, M. 672
Soysal, S. 605, 609, 612, 614
Spahrkäs, S. 168
Spałek, Mateusz J. 729
Spallek, J. 866
Sparber-Sauer, M. 821
Speiser, D. 275, 283, 346, 364, 408,
409, 668, 787, 912
Sperk, E. 311, 481
Spielmann, Sarah-M. 560
Spier, A. 350, 544
Spier, I. 979
Spira, A. 1022
Spitzmüller, A. 1074
Spitzner, M. 559, 865
Spix, C. 56
Spohn, C. 186
Spohn, Simon KB. 705, 719, 750, 890
Sprave, T. 719, 880, 890
Spreaco, F. 672
Spreckelsen, C. 128
Srinivasan, D. 1138, 1141
Srinivasan, S. 37, 74, 265
Sroczynski, G. 1049, 1134
Stäbler, A. 1095
Staerk, C. 80
Stahl, M. 545, 995
Stahl, P. 616
Stähr, K. 704, 717
Staib, L. 856
Stamer, T. 675
Standvoss, K. 1136
Stang, A. 95, 233, 298, 848, 882
Stange, D. 590, 734
Starling, N. 711
Stäudle, J. 768
Stec, J. 270
Steckelberg, A. 650, 786
Stecklum, M. 600, 871
Stefanovic, M. 672
Stefanowicz, S. 311, 528
Steel, J. 729
Steens, J. 1124
Steens, K. 93
Stegen, S. 283, 408, 787
Steiger, K. 468, 598
Stein, A. 35, 240, 492
Stein, B. 646
Stein, U. 267, 761, 775
Steinbach, J. 518
Steindorf, K. 77, 127, 210, 212, 536, 955
Steinestel, J. 100
Steinger, B. 428
Steinhäuser, J. 675
Steininger, A. 468
Steinke-Lange, V. 524, 577, 584,
803, 836, 858, 979
Steinle, Julia A. 994
Steinmeier, T. 717
Stelmach, R. 55, 100, 906
Stengel, A. 390
Stenzinger, A. 598, 851
Stephan-Falkenau, S. 965
Sternberg, Cora N. 37, 74, 83
Stewart, R. 1079
Stickeler, E. 326, 845
Stilgenbauer, S. 260, 268, 549, 732, 884
Stillger, Maren N. 446
Stintzing, S. 305, 645, 649, 690,
735, 827
Stjepanovic, N. 999
Stobart, H. 481
Stock, S. 350, 544, 646
Stocker, G. 492
Stöckle, M. 1124
Stoecklein, Nikolas H. 864, 917
Stoever, I. 755
Stögbauer, F. 598, 851
Stöhr, M. 615
Stoian, Raluca G. 719, 880
Stoklossa, C. 994
Stolle, J. 424
Stolz, R. 17, 256, 347, 813
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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index280
Stölzel, F. 828, 859, 860, 866, 920
Stork, T. 768
Stössel, S. 333, 672
Stout, T. 1075
Strassburg, Christian P. 304
Straube, C. 134
Strauß, A. 100
Strauss, C. 123, 124, 125
Strauss, G. 426
Strebhardt, K. 949
Strentzsch, J. 809
Strick, C. 1125
Strickler, J. 818
Strieer, Jana K. 188, 729
Stritzke, F. 306, 938
Strobel, H. 363, 806
Ströbel, P. 700, 876
Strohbücker, B. 687
Strotmann, J. 770, 776
Strouse, B. 540, 784
Strube, K. 768
Strüder, Daniel F. 424
Strupp, J. 992
Stuck, Boris A. 325
Stuebs, F. 541, 747
Stuehrenberg, A. 452
Stuiver, Martijn M. 212, 536
Sturm, M. 1095
Stürzl, M. 79, 657
Stuschke, M. 511, 1070
Stutzki, A. 558
Su, Wu-C. 360
Suditsch, M. 1140
Sugawara, S. 62, 989
Sujenthiran, A. 455
Sukeepaisarnjaroen, W. 377
Suksombooncharoen, T. 708
Sülberg, H. 897, 902
Sulene Cunha Sousa, O. 1000
Sulzer, S. 764
Sun, K. 712
Sun, T. 1022
Sun, W. 376
Sunpaweravong, P. 351
Surace, M. 1074
Surmann, B. 663, 842
Surovtsova, I. 504
Susanne, B. 595
Sutter, C. 979
Suzuki, H. 74
Suzuki, K. 334
Swart, E. 56
Sweegers, Maike G. 212
Szijgyarto, Z. 711, 999
Szotyori-Artz, G. 504
Sztankay, M. 1005
T
Tabatabai, G. 518, 811
Tabernero, J. 502, 818, 1000
Tahara, M. 1133
Tahmasbi Rad, M. 949
Tak, Won Y. 370
Takahashi, H. 375, 708
Takahashi, M. 196
Takes, M. 614
Talbot, C. 481
Talbot, T. 342
Tallarek, M. 866
Tam, Constantine S. 549, 567, 578
Tam, Vincent C. 377
Tamaskovics, B. 875
Tamm, I. 49
Tan, B. 372, 708
Tanasanvimon, S. 370
Tancredi, A. 1103
Tannapfel, A. 504, 1055
Tanner, C. 143
Tanzer-Küntzer, S. 1071
Taran, Florin-A. 661, 741, 931
Tari, S. 877
Tas, K. 1126
Tatagiba, M. 518
Tatzber, A. 450
Taube, Janis M. 345
Taugner, J. 415
Tausch, E. 636
Tchaikovski, S. 107
Tecklenburg, J. 594
Tehfe, M. 70
Tehlirian, C. 251
Telli, M. 175
Ten Bokkel-Huinink, D. 536
Tenckho, S. 53
Teresi, Rosemary E. 745
Terhaag, J. 49
Terwey, Jan-H. 722
Tesch, H. 1040
Tessoulin, B. 567
Testa, L. 423
Testori, M. 1074
Tetzner, K. 630
Tewes, M. 385
Thaiss, Wolfgang M. 732
Thamm, R. 816
Thanopoulou, E. 1075
Theall, Kathy P. 182, 214
Theegarten, D. 511, 1070
Theen, S. 410
Theiß, U. 325
Theißen, T. 637
Thelen, M. 88, 590
Theodoraki, Marie-N. 268, 460
Theurich, S. 1063
Thiel, K. 595
Thiele, J. 12
Thiele, Klaus-P. 1137
Thiem, D. 160
Thilakatathne, P. 697
Thomas, C. 986
Thomas, E. 734
Thomas, M. 221
Thomas, M. 296
Thomas, M. 995
Thomas, P. 408, 787
Thompson, A. 745
Thompson, Philip A. 578
Thomsen, A. 880
Thomssen, C. 486
Thronicke, A. 48, 51, 393
Thungappa, Satheesh C. 377
Thurner, A. 1005, 1011
Thuss-Patience, P. 396
Thy, S. 1012
Tiede, A. 190, 843
Tiegges, S. 721
Tielsch-Nebel, R. 271
Tiemann, M. 660
Tiller, D. 153
Timmer, M. 742
Timmermann, B. 704, 717, 821
Timotheou, A. 304
Tinhofer-Keilholz, I. 332, 449
Tippelt, S. 821
Tischler, V. 239
Tischo, I. 1055
Todorovic, J. 876
Toetome, L. 739
Tolaney, Sara M. 196, 423
Toma, M. 304
Tomaschko, K. 813
Tomasek, J. 502
Tombal, B. 37, 74, 83
Tometten, M. 875
Tomita, Y. 1057
Toncheva, P. 750
Topp, M. 583, 589
Torgunrud, A. 761
Torke, S. 775
Tougeron, D. 372
Traidl-Homann, C. 295, 537
Trakin, A. 1085
Trappe, Ralf U. 722
Traub, F. 824
Traut, A. 545
Traut, M. 419
Trautmann, H. 76
Trautmann, K. 318
Trelinska-Finger, A. 396
Trepel, M. 779
Trevaskis, M. 536
Tribian, N. 191
Triegla, U. 308
Trillsch, F. 151
Trinks, A. 305
Trocchi, P. 56
Trojan, L. 834, 839
Trommer, M. 52, 311, 358
Trommer, S. 52
Troost, Esther G. C. 986
Troschke-Meurer, S. 800
Trumet, L. 942
Trümmler, J. 525
Truppel-Hartmann, A. 43, 237, 334, 1060
Tryfonidis, K. 762
Trzeciak, E. 160
Tsai, Donald E. 549, 567, 578
Tseng, Ying-J. 495
Tsurutani, J. 762
Tucci, A. 251
Tüchler, A. 280
Tuchscherer, A. 740, 754
Tufman, A. 885
Tumewu, T. 76
Tunn, Per-U. 825
Turner, N. 1075
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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 281
Tüttenberg, A. 160
Tzankov, A. 605
U
Uema, D. 989
Ugocsai, P. 710
Uh, M. 1108
Uhl, W. 504, 770, 776, 856
Uhlig, A. 834, 839
Uhlig, J. 359, 492
Uhlig, J. 834, 839
Uhrig, S. 484
Uhrig, U. 267
Uibeleisen, R. 187
Ujjani, Chaitra S. 549, 567
Ulbricht, S. 366, 424
Uleer, C. 49
Ullmann, Sarah R. 757, 844
Ullrich, A. 406, 569, 572, 637, 733,
737, 738
Ulys, A. 265
Unger, C. 599, 724, 795, 944
Unger, K. 877
Unsöld, L. 296
Untch, M. 295, 537, 1053
Unterberg, A. 1034
Urban, L. 571
Uronis, H. 273
Urruticoechea, A. 536
Ürün, Y. 1057
V
Vaccaro, G. 375
Vachek, J. 675
Vahl, J. 268
Vajen, B. 594, 782
Vajkoczy, P. 376, 396, 729, 1143
Valcárcel, D. 336, 1051
Valderrama, Begoña P. 1057
Valentini, J. 17, 256, 347, 813
Valentini, L. 35, 208, 240, 781
Valle, J. 66, 372
Vallespir, Bartomeu P. 182
Vallet, S. 906
Van Cutsem, E. 273, 367, 818, 1000
van den Berg, N. 965
van der Heijden, Michiel S. 1057
van der Wall, E. 536
Van Gorp, T. 270
van Heteren, P. 748
van Hoorenbeeck, S. 697
van Kuijk, Sander M.J. 767
van Leeuwen-Snoeks, L. 536
Van Passen, C. 657
Vanoorop, Jana Nele L. 897, 902
Vannier, C. 191
Vannucchi, Alessandro M. 540, 784
Varela, M. 370
Varga, M. 493
Vasaturo, A. 1136
Vassiliadis, A. 946
Vatter, H. 363, 792, 945
Vay, S. 946
Vcev, A. 739
Veatch, A. 62
Vecchione, L. 305
Vedal, M. 262
Vega, A. 481
Vehling-Kaiser, U. 966
Vehreschild, Jörg J. 581
Veldeman, L. 481
Venerito, M. 1020
Venkataramani, V. 610, 861, 867
Venkateshan, S. 342
Verholen, F. 74
Vermeren, X. 821
Vermeulen, M. 1012
Verpoort, K. 966
Vetterlein, I. 926
Vettorazzi, E. 35, 240
Viardot, A. 378
Vibe, E. 803, 836
Vicente Baz, D. 1056
Vij, R. 1060
Villalobos-Bollen, M. 15, 296
Villwock, S. 184
Vitinius, F. 13, 646
Vlahovic, G. 711
Vlasenko, D. 698
Vodala, S. 336
Vogel, A. 66, 370, 372
Vogel, Marco M. E. 1125
Vogel-Adigozalov, S. 53
Vogelsang, H. 858
Vogler, M. 817, 873
Vogt, L. 425, 501
Voigt, K. 1037
Voigtlaender, M. 121
Voigtmann, R. 622
Voland, A. 1
Volchek, Y. 251
Volk, A. 275, 979
Völkel, V. 230, 417, 428, 439, 581
Volkmar, P. 590
Vollmuth, P. 610, 861, 867
Volmerig, J. 755, 756
Volodina, T. 803, 836
Voltz, R. 557, 572, 740, 992
von Ameln, S. 584
von Bergwelt-Baildon, M. 88, 590, 650, 786
von Bubno, Nikolas Christian C. 419, 675,
712, 748
von der Emde, B. 332, 449
von der Heyde, E. 492, 689, 875
von Ellerts, A. 1063
von Grundherr, J. 35, 240, 247
von Heesen, M. 612
von Kalle, C. 965
von Krüchten, R. 854
von Lehmden, M. 828
von Levetzow, C. 271, 558, 664
von Tresckow, B. 318, 418
von Tresckow, J. 121
von Witzleben, A. 268
Vordermark, D. 52, 164, 513
Vorwerk, H. 1123, 1126
Vorwerk, J. 712
Vorwerk, U. 621
Vose, Julie M. 567
Voss, M. 518
Vössing, C. 700
Vucinic, V. 58, 76, 359, 676
Vuko, M. 1074
W
Wabro, A. 891
Wadsley, J. 1133
Waetzig, R. 759
Wagener-Ryczek, S. 736, 893
Wagner, A. 493
Wagner, A. 1140
Wagner, Anna S. 77, 127
Wagner, J. 685
Wagner, Jenny K. 283, 346, 364, 668
Wagner, M. 411
Waha, A. 363, 792
Waha, A. 275
Wahba, R. 934
Wahidie, D. 909
Wahl, Lena M. 426
Waidhauser, J. 698
Wainberg, Z. 367, 1000
Waldenberger, D. 689
Waldschmidt, D. 188, 696, 847, 856
Walewska, R. 278
Walker, P. 278
Wallenwein, A. 873
Waltenberger, M. 52, 1125
Walther, W. 267, 761, 775
Walz, S. 187, 809
Wandke, S. 221
Wandmacher, Anna M. 446
Wang, Chen-Y. 918
Wang, C. 578
Wang, J. 140
Wang, Michael L. 567
Wang, Y. 567, 578
Wang, Y. 335
Wang, Y. 270
Wang, Z. 934
Wang, Z. 1034
Wanka-Pail, E. 135
Wansch, K. 645, 649, 690
Wappenschmidt, B. 275
Ward, J. 674
Ward, T. 481
Wardelmann, E. 246
Warfsmann, J. 917
Warta, R. 1034
Wäsch, R. 335
Wasilewski, D. 376, 396, 1143
Watolla, M. 917
Webb, A. 481
Webendörfer, M. 947
Weber, A. 709
Weber, Bernhard H.F. 275
Weber, K. 892
Weber, M. 933, 939, 942,
950, 951
Weber, V. 984
Weber, W. 681, 699
Wedding, U. 833, 842
Wedeken, L. 653, 682
Wegel, S. 761
Wegen, S. 311, 358, 705, 754
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Oncol Res Treat 2024;47(suppl 1):7–283 Author Index282
Wegener, S. 676
Weg-Remers, S. 280, 681, 699
Wehinger, J. 518
Wehner, A. 1088
Wehrle, J. 620
Wei, R. 196, 423
Weichert, W. 468, 598, 851, 965
Weide, R. 966
Weigert, A. 873
Weigmann-Faßbender, S. 866
Weikel, W. 154
Weimann, S. 134
Weinberg, U. 702
Weindler, J. 754
Weinert, K. 476, 635
Weinhold, C. 276
Weinstock, N. 979
Weisel, K. 748
Weiss, L. 657
Weiß, M. 740
Weiß, T. 632
Weiß Lucas, C. 518
Weissenstein, U. 632
Weissmann, T. 311
Weist, P. 700
Weitmann, K. 410, 453, 629
Welker, C. 990
Wellner, Ulrich F. 446
Welslau, M. 49, 121
Welt, A. 49
Welter, V. 736
Wemmert, S. 411
Wendland, K. 20
Wendlandt, M. 803, 836
Wendler, J. 809
Wendler, O. 808
Wendt, A. 956
Wengström, Y. 212, 536
Weniger, B. 432
Wennhold, K. 88, 590
Wensing, M. 842
Wenzel, G. 391
Werle, Laura R. 962
Wermke, M. 965
Werner, D. 298
Werner, J. 946
Werner, J. 91, 1015
Werner, M. 620, 661
Werner, R. 705
Wesselmann, S. 283, 629, 747
Wessendorf, S. 4
West, Catharine ML. 481
Westhofen, G. 790
Westho, Mike-A. 363, 806
Westphalen, C. B. 514, 650, 786
Weum Abrahamsen, I. 43, 1060
Weusthof, K. 306, 938
Weuthen, P. 271
Weydandt, L. 314
White, D. 335
Wick, W. 610, 861, 867
Wickenhauser, C. 951
Wiegel, T. 816
Wiegmann, J. 55, 875
Wiehle, R. 750
Wienands, J. 865
Wienke, A. 486
Wierda, William G. 278, 549, 578
Wiesmann-Imilowski, N. 160, 647
Wiesmüller, L. 402, 801, 810
Wiestler, B. 1084
Wiesweg, M. 511, 947, 1070
Wiewrodt, D. 1081
Wikert, J. 195, 354, 371
Wild, M. 295, 537
Wild, R. 893
Wilharm, C. 740
Wilke, T. 276, 656
Willborn, K. 700
Wille, K. 856
Willich, Stefan N. 994
Wilop, S. 689
Wimberger, P. 107, 323
Winder, T. 345
Windhager, R. 825
Windschüttl, S. 781
Windsor, S. 672
Winkelmann, P. 493
Winkler, E. 663, 777, 833, 842
Winkler, S. 151
Winter, Katharina S. 135
Wintner, L. 1005
Winzler, C. 504
Wirth, L. 1133
Wirth, U. 1015
Wiskemann, J. 1, 143, 536, 672, 715,
812, 955
Wismar, L. 80
Wisser, S. 1055
Witt, D. 1095
Witt, J. 1095
Witt, O. 44
Witte, C. 813
Wittel, Uwe A. 856
Wittemer-Rump, S. 83
Wittenberg, I. 164
Wittenberg, T. 913
Wittig-Sauerwein, A. 854
Wittke, K. 994
Witzmann, J. 581
Wöckel, A. 170, 444
Wohlfrom, T. 577, 803, 836, 858
Wölber, L. 355
Wolf, B. 314
Wolf, J. 271, 350, 544, 664, 693, 893,
965, 1108
Wolf, S. 610, 861, 867
Wolfarth, B. 994, 1147
Wolfer, S. 503, 977
Wol, D. 673
Wol, D. 782
Wöling, S. 594
Wolfgang, W. 600, 871
Wolfshöfer, S. 827
Wolmark, N. 1053
Wolniczak, E. 517
Wolters, H. 1055
Woodru, H. 767
Woods, N. 322
Woopen, H. 994
Worthy, G. 1131
Woyach, Jennifer A. 278, 549, 567
Wright, P. 672
Wrobel, D. 49
Wu, B. 251
Wu, C. 722
Wu, F. 43, 1060
Wu, X. 934
Wu, Yi-L. 1018
Wuerein, D. 274
Wul, B. 738
Wul, J. 704, 717
Wul, T. 860
Wulf-Goldenberg, A. 600
Wunderlich, H. 1124
Wunsch, K. 355
Wünsch, A. 646, 667, 878
Wurmthaler, L. 541, 624
Wurschi, G. 358
Würstlein, R. 151
Würzberg, P. 834
Wüstefeld, H. 393, 632
Wypyrsczyk, L. 333, 547
Wyrwicz, L. 70, 140, 1000
X
Xicoy, B. 251
Xing, B. 722
Xiong, J. 375
Xiong, Y. 656
Xu, J. 94
Xu, P. 636
Xu, R. 376, 396
Xu, T. 175
Xu, T. 1018
Xyländer, M. 878
Xynos, I. 1000
Y
Yacoub, A. 540
Yakushev, I. 1084
Yamaguchi, K. 70, 367
Yamazaki, N. 388
Yan, S. 267
Yang, L. 917
Yang, S. 762, 818
Yang, S. 375
Yang, Y. 273
Yang, Z. 502
Yannakou, Costas K. 251
Yao, J. 273
Yao, James C. 502
Yao, R. 305
Yarchoan, M. 351
Yau, T. 351
Yavas, A. 785
Ye, D. 74, 1057
Yen, Priscilla K. 367
Yildirim, N. 817
Yılmaz-Aslan, Y. 909
Yoh, K. 360
Yong, Alan S. M. 343
Yong, Yong S. 79
Yoshino, T. 502, 711, 818
You, J. 345
Young, T. 1011
Yousean, S. 688
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Oncol Res Treat 2024;47(suppl 1):7–283Author Index 283
Youssef, B. 61
Yuan, Y. 571
Yücel, M. 661
Yun, Yeong C. 610, 861, 867
Yurttas, C. 595
Z
Zacher, S. 786
Zahn, Anna L. 541
Zahn, C. 186
Zaiss, M. 423
Zamboglou, C. 705, 750, 890
Zander, T. 271, 273, 693, 754
Zapf, A. 569
Zaporozhchenko, Y. 621
Zaucha, R. 66
Zebger-Gong, H. 360, 989
Zech, Christoph J. 605, 614
Zedler, P. 910
Zeeb, H. 1088
Zeh, A. 164
Zeidan, Amer M. 336, 1051
Zeindler, J. 612, 614
Zeissig, S. 629
Zelenetz, Andrew D. 567
Zeltner, V. 710
Zeman, F. 561
Zengerling, F. 906, 1122
Zenner, HP 168
Zeuschner, P. 839
Zhang, A. 175
Zhang, D. 786
Zhang, J. 336, 1051
Zhang, J. 273
Zhang, L. 674
Zhang, W. 62
Zhang, W. 83
Zhang, Y. 989
Zhao, J. 934
Zhao, Q. 251
Zhao, Y. 934
Zhaoran, S. 316
Zhen, David B. 66
Zhong, W. 1018
Zhou, C. 934
Zhou, C. 1108, 1131
Zhou, D. 367
Zhou, T. 304
Zhou, Z. 335
Zhu, D. 335
Ziegler, David A. 327
Ziegler, S. 327
Zielonka, S. 800
Ziepert, M. 1054
Zieschang, C. 83
Zilski, N. 346, 364, 668, 912
Zimmer, E. 1138
Zimmer, N. 160
Zimmer, P. 536
Zimmermann, A. 378
Zimmermann, J. 1079
Zimmermann, T. 362, 874
Zimovjanova, M. 61
Zinnow, V. 761
Zinzani, Pier L. 549, 567
Zipfel, S. 390
Zipp, M. 1112
Zips, D. 319, 368, 551, 709,
729, 816
Zischinsky, Mia-L. 267
Zitzmann, M. 655
Zivanov, M. 61
Zocholl, D. 450
Zografos, E. 711
Zopf, E. 536
Zormaier, S. 468
Zoth, N. 946
Żotkiewicz, M. 66, 372, 708
Zschäbitz, S. 55, 100, 906
Zschaeck, S. 551, 890
Zubac, D. 807, 932
Züe, S. 182
Züger, A. 663
Zühlke, O. 368
Zukov, R. 345
Zuljan, E. 332, 449
Zünkeler, M. 650
Zurawski, B. 571
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